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
Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.
Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.
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.
For more benefits information, please click here