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Salary: USD 110,000 - 140,000 / annual
Pie Insurance is seeking a Manager, Claims Vendor Management to lead the company's Claims Vendor Management program for assigned strategic vendors. This role manages relationships across multiple vendor categories including managed care services (medical bill review, pharmacy benefit management, utilization review, provider networks), legal vendors (law firms and litigation support), investigative services, support vendors (transportation, translation), and API-integrated technology vendors.
Key responsibilities include:
**Vendor Management Program Development**: Support implementation of Pie's Claims Vendor Management program, execute vendor management strategy in partnership with Claims leadership, develop vendor management team members, create centralized contract repositories, implement vendor performance frameworks, and support department-wide policies and procedures.
**Managed Care Vendor Oversight**: Provide oversight of managed care program vendors with focus on service quality, contractual compliance, and service level agreements. Monitor vendor performance impact on medical loss costs and claim outcomes. Collaborate with senior leadership on vendor strategy and portfolio optimization.
**Comprehensive Vendor Portfolio Management**: Manage day-to-day relationships across legal, investigative, support, and technology vendors. Apply tailored vendor management strategies to each category while maintaining consistent standards across all vendor types.
**Strategic Vendor Initiatives**: Support sunset programs to eliminate redundant contracts, run formal RFP processes for competitive vendor selection, lead contract negotiations and renegotiations to drive cost savings, and analyze internal vendor costs against market forces.
**Vendor Performance Management**: Facilitate quarterly/annual stakeholder meetings, collect vendor performance feedback, establish KPIs, perform billing audits, and serve as primary contact for assigned strategic vendors.
**Process Improvement & Compliance**: Support vendor transitions to improved billing practices, implement agreed optimization plans, ensure compliance with billing practices and enterprise standards, and partner with Claims, Legal, Finance, and Procurement teams.
**Cross-Functional Collaboration**: Work with Claims Operations, Regulatory Compliance, Claims Adjudication, Finance, and Legal teams to support product launches, operational needs, and strategic goals.
**Requirements**:
- Bachelor's degree in Business Administration, Finance, Supply Chain Management, or related field
- 6+ years of experience in vendor management, procurement, or strategic sourcing
- 3+ years of experience in the insurance industry, preferably in claims operations or vendor management
- 1+ years of experience leading or mentoring team members; direct people management experience a plus
- Track record of leading vendor contract negotiations and achieving cost savings
- Experience supporting or implementing vendor management programs
- Strong understanding of workers' compensation and managed care vendors landscape, legal, investigative, and support vendor categories; commercial auto vendor experience a plus
- Working knowledge of managed care services including medical bill review, pharmacy benefit management, utilization review, and provider networks
- Knowledge of legal vendor management including law firm relationships and litigation support services
- Understanding of investigative services, transportation, translation, and ancillary claims support vendors
- Exposure to API-integrated technology vendors and understanding of system integration requirements
