The Manager of Vendor Oversight: D-SNP supports sourcing, contract execution, and
performance management for vendor partners that directly support Partnership Advantage Dual
Eligible Special Needs Plan (D-SNP). This position is responsible for relationship management
with assigned vendors, as well as oversight of the contractual performance, maintenance of the
vendor to ensure performance and compliance, building governance structures (JOC/AOC),
implementing performance monitoring frameworks and ensuring all vendors meet regulatory and
operational requirements during D-SNP implementation and after go-live. This position will be
responsible for building relationships with business owners across the organization including:
Compliance, Operations, Network Contracting, IT, and Quality teams to ensure vendors are
integrated and compliant. They serve as the primary liaison between Compliance and external
partners to maintain audit readiness and operational excellence.

▪ Vendor Management

• Leads the implementation and onboarding of key DSNP vendors.
• Works with internal business partners on the management of vendor Service Level
  Agreements (SLAs) and Key Performance Indicators (KPIs). This includes receiving
  vendor reports, arranging and attending Joint Operations Meetings (JOC), reviewing,
  and documenting vendor performance and working with Compliance to assess
  corrective action plans (CAPs) where applicable.
• Collaborates with internal and external business partners on the collection, analysis,
  and maintenance of relevant data.
• Supports the development of plans and operational solutions to address changes to
  vendor programs on an annual basis.
• Develops vendor readiness plans, timelines, and deliverables aligned with CMS
  application and Annual Enrollment Period (AEP) launch milestones.
• Partners with Legal and Compliance on contracting to ensure inclusion of compliance
  and performance provisions.
• Establishes governance cadence — weekly stand-ups, monthly performance
  meetings, and readiness checkpoints.
• Leads day-to-day relationship management of delegated DSNP vendors.
• Conducts regular vendor performance monthly reviews and quarterly business
  reviews (QBRs).
• Ensures vendors adhere to operational timelines, data quality standards, and reporting
  requirements.

▪ Compliance and Regulatory Management

• Supports Compliance and Regulatory teams to prepare for CMS and state readiness
  reviews, including submission of vendor documentation.
• Ensures that the D-SNP Program and related processes adhere to regulatory and
  contractual requirements, laws, accreditation standards, and regulations, including
  Medicare Advantage, Centers for Medicare and Medicaid (CMS), Department of
  Managed Health Care (DMHC), and the Affordable Care Act.
• Collaborates with Compliance, Quality, and Regulatory Affairs to ensure delegated
  oversight program meets CMS requirements.
• Reviews and validates vendor compliance attestations and documentation (policies,
  procedures, training, etc.).

▪ Delegation Oversight

• Develops metrics and reports to monitor the effectiveness of the D-SNP program,
  evaluating D-SNP program initiatives to improve performance, and recommending
  adjustments as necessary.
• Ensures vendor deliverables meet CMS standards.
• Supports development and maintenance of the Model of Care (MOC) by aligning
  vendor capabilities (e.g., case management, HRA completion, care coordination).

▪ Operational Integration

• Partners with DSNP Operations, Compliance, and IT teams to monitor data
  exchange and reporting accuracy (e.g., encounter data, care coordination files, etc.).
• Supports readiness for AEP and ongoing operations through vendor readiness
  assessments.
• Monitors vendor-related STARs, quality, and member experience metrics.

All HealthPlan employees are expected to:

• Provide the highest possible level of service to clients;
• Promote teamwork and cooperative effort among employees;
• Maintain safe practices; and
• Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$118,518.94 - $154,074.63

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.