Senior Network Vendor Manager

Company: Hispanic Alliance for Career Enhancement
Location: San Jose
Posted on: June 1, 2025

Job Description:

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels, and more than 300,000 purpose-driven colleagues-caring for people where, when, and how they choose in a way that is more connected, more convenient, and more compassionate. We do it all with heart, each and every day.Effectively manages complex contractual relationships with TPAs and/or business partners in Europe, APAC, Africa, and the Middle East (excluding the Americas) to support international network, medical cost management, and claim/customer service strategies. Provides concierge-level service to members through timely network access and proactive relationship management to ensure seamless direct settlement access.Job Responsibilities:

• Manage TPA relationships with external vendors and oversee overall relationship management in Europe, Africa, Middle East, and APAC.
• Oversee contractual relationships with assigned TPAs.
• Manage Third Party Risk Governance processes for assigned TPAs.
• Conduct ongoing compliance reviews of TPAs.
• Manage monthly billing and invoice submissions for timely payments.
• Review and upload TPA networks on internal systems timely.
• Update TPA guides, country guides, and other internal materials regularly.
• Streamline member experience at each country level by evaluating network options and optimizing utilization.
• Own operational issues from TPAs and resolve swiftly.
• Negotiate and manage complex contracts with providers/vendors, expanding the international provider network by contracting new direct pay providers.
• Serve as a subject matter expert to support internal teams and external clients on network and TPA inquiries.
• Manage operational issues related to TPAs.
• Oversee provider operations to ensure efficiency through proactive education and collaboration.
• Implement regional and client-specific strategies to meet market expectations and client needs.
• Manage medical cost issues from the provider perspective and initiate appropriate actions.
• Contribute to the development and management of provider portals and digital solutions.
• Coordinate legal reviews when necessary.Required Qualifications:
  • Experience in Benefits Management and interacting with Medical Professionals.
  • Strong project management skills.
  • Prior client-facing experience.
  • Vendor relationship management skills.
  • Business acumen and industry knowledge.
  • Experience managing competitive networks.Preferred Qualifications:
    • Leadership qualities and a global perspective.
    • Understanding of health insurance and business negotiations.
    • Service-oriented mindset and discipline.Education:
      • Bachelor's degree preferred or equivalent professional experience.Pay Range:The typical pay range is $67,900 - $199,144 annually, depending on experience, education, and location. The role may include bonuses, commissions, or equity awards.Benefits:Our benefits include medical plans, 401(k) with matching, stock purchase plans, wellness programs, paid time off, flexible schedules, family leave, dependent care resources, tuition assistance, and more. For details, visit .Application deadline: 06/21/2025. Qualified applicants with arrest or conviction records will be considered in accordance with laws.
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Keywords: Hispanic Alliance for Career Enhancement, Merced , Senior Network Vendor Manager, Executive , San Jose, California