DELEGATION AND VENDOR OVERSIGHT MANAGER, HEALTH PL

at Cook County Government in Chicago, Illinois, United States

Job Description

Job Posting:Jun 14, 2024, 8:38:39 PMClosing Date:Jun 29, 2024, 4:59:00 AMFull-timeShift Start Time:8:30A.M.Shift End Time:4:30P.M.

Posting Salary:COMPETITIVE SALARY
Organization:Health and Hospital Systems

LOCATION: Health Plan Services - 4896
SHIFT: 8:30AM - 4:30PM

Job Title

Delegation and Vendor Oversight Manager, Health Plan Services 
Department

CountyCare/Managed Care

This position is exempt from Career Service under the CCH Personnel Rules.

Job Summary
The Delegation and Vendor Oversight (DVO) Manager, Health Plan Services is responsible for providing assistance with oversight of delegates and vendors contracted with CountyCare.This position will be onboard and monitor delegates and vendor contracts and relationships. Manages an expanding managed care population for Medicaid and Medicare and implements enhanced capabilities for accountability and integrity of daily operations. Adheres to fraud and abuse prevention and/or detection policies and programs according to regulatory requirements.

General Administrative Responsibilities

Collective Bargaining
*Review applicable Collective Bargaining Agreements and consult with Labor Relations to generate management proposals
*Participate in collective bargaining negotiations, caucus discussions and working meetings

Discipline
*Document, recommend and effectuate discipline at all levels
*Work closely with labor relations and/or labor counsel to effectuate and enforce applicable Collective Bargaining Agreements
*Initiate, authorize and complete disciplinary action pursuant to CCH system rules, policies, procedures, and provision of applicable collective bargaining agreements

Supervision
*Direct and effectuate CCH management policies and practices
*Access and proficiently navigate CCH records system to obtain and review information necessary to execute provisions of applicable collective bargaining agreements

Management
*Contribute to the management of CCH staff and CCH' systemic development and success
*Discuss and develop CCH system policy and procedure
*Consistently use independent judgment to identify operational staffing issues and needs and perform the following functions as necessary; hire, transfer, suspend, layoff, recall, promote, discharge, assign, direct or discipline employees pursuant to applicable Collective Bargaining Agreements
*Work with Labor Relations to discern past practice when necessary
Typical Duties
*Performs pre-delegation and annual audits per regulatory, State, and accreditation standards for all delegates.
*Assists on onboarding new delegates and vendors and measuring each delegate and vendors Key Performance Indicators and contracted metrics.
*Remains current with each delegate and vendor contracts and scope of work and updating scope of works as needed.
*Establishes a strong relationship with each vendor and contractor to meet set key performance indicators.
*Participates and may facilitate Joint Operation Meetings including Delegation and Vendor Oversight Committee.
*Assists drafting Request for Proposals and collaborating with Supply Chain Management Procurement process.
*Takes corrective action as necessary to address disciplinary concerns; makes recommendations to diminish the impact on productivity.
*Implements enhanced capabilities for accountability and integrity of daily operations.
*Plans and directs all aspects of the operations for assigned products and programs.
*Oversees all aspects of assigned products and programs, establishing objectives, policies and procedures.
*Ensures operational processes and policies are compliant with corporate standards and applicable local, state, and federal regulations.
*Provides resolutions to managed care contractual issues pertaining to contract interpretation.
*Adheres to confidentiality standards and HIPAA compliance programs.
*Performs other duties as assigned.

Minimum Qualifications
*Bachelor's degree from an accredited college or university is required (official transcript is due to at the time of interview)
*Two (2) years of health plan experience in a Medicare health plan, Medicaid health plan, or health system including aspects of operations oversight, administration, management, delegation, and vendor oversight is required
*One (1) year of experience managing delegates and vendor relationships such as a Third-Party Administrator, Vision, Dental, and Transportation vendors and Pharmacy Benefit Manager, etc. is required
*Intermediate proficiency with Microsoft Office Suite (Access, Excel, PowerPoint and Word) is required (MS Office testing will be administered, 70% minimum proficiency rate is required)

Preferred Qualifications
*Master's degree from an accredited college or university is preferred (official transcript is due to at the time of interview)

Knowledge, Skills, Abilities... For full info follow application link.

COOK COUNTY HEALTH AND HOSPITALS SYSTEM IS AN EQUAL OPPORTUNITY EMPLOYER