Job Details
The Delegated Vendor Program Manager is responsible for the strategic oversight and operational performance of HHAeXchange as a primary delegated partner for Jefferson Health Plans. In this role, you serve as the central point of contact for the HHAX platform, ensuring it effectively supports the distribution of authorizations and the collection of visit data for our provider network. You are tasked with "delegation oversight," which involves monitoring the vendor's adherence to contract terms, managing Service Level Agreements (SLAs), and ensuring that the platform remains fully compliant with the Pennsylvania Department of Human Services (DHS) and Office of Long-Term Living (OLTL) regulatory frameworks.
As the program lead, you bridge the gap between Jefferson’s internal departments—such as Finance, Compliance, and Clinical Operations—and the external vendor. You will lead regular performance reviews, oversee the technical integrity of data integrations, and manage the annual delegation audit process to mitigate operational and financial risk. By ensuring that HHAeXchange functions seamlessly as a "system of record," you enable Jefferson Health Plans to maintain high provider satisfaction, ensure accurate claims adjudication for Community HealthChoices (CHC) members, and remain 100% audit-ready for state and federal reporting
Job Description
Summary
The Delegated Vendor Program Manager is responsible for the strategic oversight and operational performance of HHAeXchange as a primary delegated partner for Jefferson Health Plans. In this role, you serve as the central point of contact for the HHAX platform, ensuring it effectively supports the distribution of authorizations and the collection of visit data for our provider network. You are tasked with "delegation oversight," which involves monitoring the vendor's adherence to contract terms, managing Service Level Agreements (SLAs), and ensuring that the platform remains fully compliant with the Pennsylvania Department of Human Services (DHS) and Office of Long-Term Living (OLTL) regulatory frameworks.
As the program lead, you bridge the gap between Jefferson’s internal departments—such as Finance, Compliance, and Clinical Operations—and the external vendor. You will lead regular performance reviews, oversee the technical integrity of data integrations, and manage the annual delegation audit process to mitigate operational and financial risk. By ensuring that HHAeXchange functions seamlessly as a "system of record," you enable Jefferson Health Plans to maintain high provider satisfaction, ensure accurate claims adjudication for Community HealthChoices (CHC) members, and remain 100% audit-ready for state and federal reporting
Job Duties
- Manage end-to-end lifecycle of delegated vendor partnerships, from onboarding through
- Serve as the primary point of contact for delegated vendors and internal stakeholders.
- Foster collaborative, transparent relationships to ensure alignment with organizational goals.
- Define, track, and report on key performance indicators (KPIs) and service level agreements (SLAs).
- Analyze vendor performance data and implement continuous improvement strategies.
- Escalate and resolve vendor-related performance issues effectively.
- Maintain accurate documentation for all delegated vendor activities, reviews, and decisions.
- Work closely with Compliance, Legal, Operations, and IT teams to align vendor performance with organizational priorities.
- Participate in internal and external audits related to delegated functions.
- Review, validate, and approve vendor invoices in accordance with contract terms and organizational policies.
- Ensure timely and accurate processing of payments and resolve discrepancies or disputes related to invoicing.
- Monitor vendor budgets, spending trends, and maintain financial compliance.
Minimum Qualifications
- Bachelor's degree in business administration, Healthcare Administration, Public Health
- Masters preferred.
- 3 years in Vendor management and Procurement
- Strong knowledge of contract management and vendor relationship management.
- Exceptional communication, negotiation, and interpersonal skills.
- Strong organizational and project management abilities.
Preferred Qualifications
- Master’s Degree in Business Administration or
- Master’s Degree in Healthcare Administration or
- Experience in a healthcare industry
- Familiarity with delegated credentialing, utilization management, or claims processing.
- Knowledge of NCQA, CMS, and other industry standards.
- Microsoft Excel Proficiency
Physical Demands
Lift and carry 7 lbs., continuous sitting >67%, frequent keyboard use/repetitive motion, frequent fine motor activity/wrist position deviation.
Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.
Work Shift
Workday Day (United States of America)
Worker Sub Type
Regular
Employee Entity
Health Partners Plans, Inc.
Primary Location Address
1015 Chestnut Street, Philadelphia, Pennsylvania, United States of America
Benefits
Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.
