Director – Vendor Management

Come Grow With Us
At Gold Coast Health Plan, we are driven to create the health plan of the future - today. We are disrupting the conventions of the health care industry by creating and applying leading-edge solutions to its many challenges.

Working at Gold Coast Health Plan means working alongside a team of committed individuals who are reshaping the organization and redefining how the needs of the whole person – health, health care, and social services and supports – are met. We are seeking collaborators, innovators, and those who are driven to be their very best.

If you are looking for a career of purpose and are passionate about having an impact on society’s health care challenges, then Gold Coast Health Plan is where you should be. Here, you will be challenged and rewarded in equal measure.

About this role:

Reasonable Accommodations Statement

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

**This position is open to California residents only.**

ESSENTIAL FUNCTIONS

Job Function & Responsibilities

Enterprise Vendor Management Strategy

·       Develop and execute the enterprise strategy, operating model, and governance framework for third-party vendor management.

·       Establish standards, policies, procedures, and controls governing the full vendor lifecycle.

·       Align vendor strategy with organizational business objectives, healthcare operations priorities, financial goals, member experience, and quality outcomes.

·       Develop and maintain a comprehensive vendor portfolio strategy, including segmentation based on strategic importance, financial impact, operational criticality, and risk.

·       Provide executive leadership with recommendations regarding outsourcing, insourcing, vendor consolidation, strategic partnerships, and sourcing opportunities.

·       Establish appropriate governance structures for strategic, critical, and high-risk vendors.

Executive Vendor Governance & Performance

·       Provide executive oversight of strategic and critical vendor relationships.

·       Establish enterprise standards for vendor KPIs, SLAs, quality measures, performance guarantees, scorecards, and reporting.

·       Lead executive business reviews with key vendors and internal stakeholders.

·       Evaluate vendor performance trends and translate data into actionable business recommendations.

·       Ensure vendor performance is consistently aligned with contractual obligations and organizational expectations.

·       Direct the development and execution of corrective action and performance improvement plans for underperforming vendors.

·       Serve as the executive escalation point for significant or persistent vendor performance issues.

Managed Healthcare Operations

·       Provide strategic oversight of vendors supporting critical healthcare functions, services, and operational processes. Ensure vendor operations align with applicable healthcare laws, regulations, contractual requirements, accreditation standards, and organizational policies.

·       Ensure third-party services support quality, efficiency, regulatory compliance, member satisfaction, provider experience, and organizational performance.

·       Partner with operational and clinical leaders to assess vendor capabilities, service models, capacity, scalability, and operational effectiveness. Monitor vendor compliance with applicable privacy, security, quality, and business-continuity requirements.

·       Evaluate the impact of vendor performance on members, providers, clients, and other key stakeholders. Participate in audits, regulatory inquiries, risk assessments, and remediation activities involving third-party vendors.

·       Ensure vendor oversight practices are appropriate for the organization's managed care and healthcare operating environment.

Risk, Compliance & Regulatory Oversight

·       Establish an effective framework for identifying, assessing, monitoring, and mitigating third-party risk.

·       Partner with Compliance, Legal, Risk, Information Security, Privacy, and Business Continuity functions to ensure appropriate vendor oversight.

·       Ensure vendors comply with applicable healthcare laws, regulations, contractual requirements, accreditation standards, and organizational policies.

·       Provide leadership during vendor-related audits, regulatory reviews, investigations, and remediation activities.

·       Oversee risk mitigation and contingency planning for critical vendors and outsourced services.

·       Ensure appropriate documentation and evidence of vendor oversight are maintained.

Contract & Financial Management

·       Partner with Procurement, Legal, Finance, and business owners on strategic sourcing, contract negotiations, renewals, amendments, and terminations.

·       Provide strategic input into contract terms, performance requirements, service levels, financial provisions, and performance guarantees.

·       Oversee vendor financial performance, including spend, pricing, utilization, invoicing, savings opportunities, and value realization.

·       Identify opportunities to reduce costs, improve productivity, consolidate vendors, and optimize the organization's third-party portfolio.

·       Develop and present business cases and financial recommendations for significant vendor decisions.

·       Ensure vendor relationships deliver measurable value relative to contractual and operational investments.

Vendor Lifecycle & Transformation

·       Provide executive oversight of vendor selection, due diligence, implementation, transition, optimization, renewal, and termination.

·       Lead complex vendor transitions and enterprise initiatives involving significant operational or member impact.

·       Ensure implementation and transition plans appropriately address operational readiness, technology, staffing, communications, compliance, and business continuity.

·       Establish exit strategies and contingency plans for critical third-party relationships.

·       Drive transformation initiatives designed to improve the organization's vendor operating model and overall third-party performance.

Strategic Risk & Issue Management

·       Monitor the organization's overall vendor risk profile and identify emerging operational, financial, regulatory, reputational, and business-continuity risks.

·       Establish escalation frameworks for high-impact vendor incidents and recurring performance issues.

·       Lead cross-functional executive response to critical vendor events.

·       Ensure root-cause analysis, remediation, and preventive actions are completed for significant issues.

·       Regularly communicate vendor risks, mitigation strategies, and emerging concerns to executive leadership.

Leadership & Organizational Development

·       Lead, develop, and retain a high-performing vendor management team.

·       Establish clear organizational goals, performance expectations, accountability structures, and professional development opportunities.

·       Manage, select, evaluate, train, lead and direct staff in support of strategic and business efforts. Build an effective team and ensure appropriate staffing and staff development

·       Lead staff by fostering teamwork and collaboration, driving employee engagement as well as leveraging diversity and inclusion. Carry out supervisory responsibilities in accordance with company's policies and regulatory requirements

·       Build a scalable vendor management operating model appropriate for the organization's size, complexity, and growth.

·       Foster strong partnerships across Operations, Clinical, Finance, Procurement, Legal, Compliance, IT, Risk, and other enterprise functions.

·       Influence senior leaders and stakeholders across a matrixed organization to achieve shared business objectives.

·       Represent Vendor Management in senior leadership forums, enterprise initiatives, and strategic planning activities.

·       Establish a culture focused on proactive risk management, data-driven decision making, operational excellence, and continuous improvement.

Executive Reporting & Analytics

·       Develop executive-level reporting that provides visibility into vendor performance, financial impact, risk, compliance, service quality, and strategic opportunities.

·       Establish dashboards and reporting mechanisms that enable proactive identification of trends and emerging risks.

·       Present vendor portfolio performance and strategic recommendations to senior and executive leadership.

·       Use data and analytics to inform vendor strategy, investment decisions, performance interventions, and resource allocation.

MINIMUM QUALIFICATIONS

Education & Experience:

• Bachelor's degree in Business Administration, Healthcare Administration, Operations, Supply Chain, Finance, or a related field.
• 10+ years of progressive experience in vendor management, healthcare operations, outsourcing, procurement, third-party management, or a related discipline.
• 5+ years of experience in a leadership capacity, including responsibility for teams, enterprise programs, strategic vendor relationships, or complex cross-functional initiatives.
• Demonstrated knowledge of managed healthcare operations and the complexities of working within a highly regulated healthcare environment.
• Proven ability to develop and execute enterprise-level strategies and operating models.
• Strong knowledge of vendor governance, contract management, SLA/KPI development, performance management, financial oversight, and third-party risk management.
• Demonstrated experience managing strategic or complex third-party vendor relationships.
• Demonstrated executive presence and ability to communicate effectively with senior and executive leadership.
• Exceptional negotiation, analytical, strategic planning, problem-solving, and decision-making skills.
• Demonstrated ability to influence across organizational boundaries and lead through complex, matrixed environments.
• Strong written and verbal communication and executive presentation skills.
• Strong interpersonal skills including coaching staff and handling conflict resolution, implementing initiatives or projects, and collaborating with other professional and non-clinical staff.
• Demonstrated ability to select, motivate, and evaluate staff, and provide for their training and professional development.
• Demonstrated ability to work in a fast-paced, diverse organization that is performance oriented.
• Proficiency with Microsoft Office and experience with vendor-management, contract-management, GRC, business-intelligence, or reporting platforms.

KNOWLEDGE, SKILLS & ABILITIES       

Preferred Qualifications:

• Master's degree in Business Administration, Healthcare Administration, Supply Chain, or a related field.

• Experience overseeing vendors supporting claims, utilization management, care management, member services, provider operations, network management, pharmacy, clinical services, or other delegated healthcare functions.

• Experience with Medicare Advantage, Medicaid, commercial health plans, or other managed care programs.

• Experience with delegated vendor oversight and healthcare regulatory/accreditation requirements.

• Experience leading enterprise-wide vendor rationalization, strategic sourcing, or cost-optimization initiatives.

• Experience presenting vendor portfolio performance, risk, and financial recommendations to executive leadership or a board-level committee.

• Professional certification in vendor management, procurement, supply chain, project management, risk management, or healthcare administration.

Candidates should demonstrate significant experience in the following areas:

·       Enterprise vendor management: Developing or leading a vendor management program, operating model, governance framework, or strategic vendor portfolio.

·       Managed healthcare: Experience within a health plan, managed care organization, third-party administrator, healthcare services organization, healthcare technology company, or comparable healthcare environment.

·       Strategic vendor relationships: Managing complex, high-value, high-volume, strategically important, or high-risk third-party relationships.

·       Executive governance: Leading executive business reviews, vendor governance committees, strategic partnership discussions, and senior-level escalations.

·       Performance management: Establishing and managing SLAs, KPIs, scorecards, quality metrics, performance guarantees, and corrective action programs.

·       Contract and financial management: Experience with contract negotiations, renewals, pricing, financial analysis, vendor spend, savings initiatives, and value realization.

·       Third-party risk: Experience managing vendor operational risk, regulatory requirements, compliance, privacy, security, business continuity, and audit activities.

·       Transformation: Leading vendor implementations, transitions, consolidations, outsourcing/insourcing initiatives, operating-model transformations, or other enterprise-scale change initiatives.

·       Cross-functional leadership: Demonstrated success partnering with Operations, Clinical, Finance, Procurement, Legal, Compliance, Risk, IT, and executive stakeholders.

·       People leadership: Experience hiring, developing, coaching, and leading high-performing teams and establishing organizational capabilities.

·       Data-driven management: Experience using financial, operational, quality, and performance data to identify trends, make strategic decisions, and communicate recommendations to executive leadership.

Technology & Software Skills: Advanced computer skills in MS Office products.

Certifications & Licenses: A valid and current Driver's License, Auto Insurance, and professional licensure(s)

Competency Statements

• Management Skills - Ability to organize and direct oneself and effectively supervise others.

• Business Acumen - Ability to grasp and understand business concepts and issues.

• Decision Making - Ability to make critical decisions while following company procedures.

• Goal Oriented - Ability to focus on a goal and obtain a pre-determined result.

• Interpersonal - Ability to get along well with a variety of personalities and individuals.

• Diversity Oriented - Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type.

• Time Management - Ability to utilize the available time to organize and complete work within given deadlines.

• Consensus Building - Ability to bring about group solidarity to achieve a goal.

• Relationship Building - Ability to effectively build relationships with customers and co-workers.

• Presentation Skills - Ability to effectively present information publicly.

• Delegating Responsibility - Ability to allocate authority and/or task responsibility to appropriate people.

• Leadership - Ability to influence others to perform their jobs effectively and to be responsible for making decisions.

• Strategic Planning - Ability to develop a vision for the future and create a culture in which the long-range goals can be achieved.

• Ethical - Ability to demonstrate conduct conforming to a set of values and accepted standards.

• Judgment - The ability to formulate a sound decision using the available information.

• Communication, Oral - Ability to communicate effectively with others using the spoken word.

• Communication, Written - Ability to communicate in writing clearly and concisely.

• Problem Solving - Ability to find a solution for or to deal proactively with work-related problems.

The estimated pay range for the position is:

$157,303.00 - $262,697.00

The pay range above represents the minimum and maximum rate for this position in California. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. Salary range will vary for remote positions outside of California and future increases will be based on the pay band for the city and state you reside in.

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