Gravie - Clinical Vendor Manager
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Requirements
• · Active and non restricted RN license • · 3+ years experience managing clinical vendors (UM/CM, telehealth, care navigation, etc.) in payer or managed care settings. • · Demonstrated success improving vendor performance and managing complex contracts. • · Working for a TPA and/or Self funded insurance organizations. • · Working with Stop Loss and Reinsurance vendor partners. • · Strong organizational and project management skills. • · Excellent relationship-building and communication abilities. • · Proficiency in data analysis and vendor performance dashboards. • · Knowledge of healthcare quality, utilization management, and medical cost containment. • · Comfortable working in a fast-paced, evolving environment. • In order to transform health insurance and build a health plan everyone can love, we need talented people doing amazing work. In exchange, we offer a great overall employee experience with opportunities for career growth, meaningful mission-driven work, and an above average total rewards package. • The salary range for this position is $113,800 - $189,600 annually. Numerous factors including, but not limited to, educations, skills, work experience, certifications, etc. will be considered when determining compensation. • Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard health and wellness benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, up to 16 weeks paid parental leave, paid holidays, a 401k program, cell phone reimbursement, transportation perks, education reimbursement, and 1 week of paid paw-ternity leave.
Responsibilities
• · Serve as the primary point of contact for clinical vendors (including Cigna UM & CM, AHH UM & CM, Teladoc, Sword Health, Alight, and SL partners). • · Maintain strong, collaborative relationships to ensure mutual accountability and continuous improvement. • · Partner with internal clinical, finance, and operations teams to align vendor services with Gravie’s goals. • · Strategize and evaluate potential clinical vendors to identify partnerships that add measurable value and align with organizational goals. • · Monitor vendor performance against SLAs, KPIs, and contract terms; escalate issues and track remediation plans. • · Manage ongoing and annual vendor evaluations, including data reviews and performance scorecards. • · Identify performance gaps and opportunities for cost containment and quality improvement. • · Support contract renewals, amendments, and performance guarantees (PGs) in partnership with Legal and Procurement. • · Ensure vendor compliance with contractual, regulatory, and audit requirements. • · Track key contract dates and coordinate renewal reviews and approvals. • · Define and enforce clinical vendor data reporting standards and integration requirements across systems. • · Prepare regular dashboards and summaries highlighting performance trends, risks, and opportunities. • · Translate data insights into actionable recommendations for leadership. • · Support decisions on insourcing vs. outsourcing functions by assessing cost, quality, and efficiency impacts. • · Reconcile vendor invoices and proactively forecast clinical vendor spend. • · Collaborate cross-functionally to resolve issues affecting member experience or clinical outcomes.
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