Network and Vendor Operations Manager (Health Plan)

About myPlace Health

myPlace Health was founded in 2021 by mission-aligned healthcare leaders and organizations that are committed to drastically improving health outcomes, quality and experience for vulnerable older adults and frail seniors. We specialize in providing value-based, comprehensive care and coverage for older adults with significant needs so they can thrive in the homes they love and in the communities they cherish. 

Our mission is simple: to enable older adults to live the independent lives they deserve. We pursue this mission through our myPlace PACE (Program of All-Inclusive Care for the Elderly) model, which provides seamless primary care, integrated health plan coverage, personalized social engagement, and customized services delivered in the participant’s preferred place.  

myPlace Health is building a mission-driven team that shares our passion for redefining the way older adults experience care as they “age in place” in the community. This is a unique opportunity to take on one of our country’s most challenging healthcare problems and join a fast-growing, dynamic team as we prepare to scale our mission to serve more markets. 

About this Role

This role presents an exciting opportunity for a mission-driven individual to play an integral role in establishing the oversight and management of vendor and provider network partnerships for our integrated care delivery startup. This teammate will report to the Senior Director of Health Plan Operations and will be responsible for building, scaling, and continuously improving our vendor management and provider network functions, in addition to other important activities. The role will lead the continued development and improvement of the myPlace Health vendor procurement process, contract management life cycle and provider network administration, and will support Operations, Information Technology and other key departments in KPI development and tracking for vendors. This team member will also maintain a highly organized contract repository and network management system. As one of the inaugural members of our health plan operations team, this leader will set the tone in how we develop sound, compliant, and efficient health plan operations that enable us to scale our model effectively and responsibly. 

• Manage and provide third party oversight including attestation tracking, vendor governance, auditing oversight, risk management, credentialing and ensuring necessary vendor trainings are up to date
• Identify opportunities to build positive business relationships with potential providers by connecting within the community along with other myPlace leaders
• Develops contractual relationships with service providers,  drafts contract agreements, and maintains provider network listings
• Partnership with Quality and Compliance team on the establishment of mock audits in preparation for future State and CMS audit readiness
• Support provider network administration, including managing our catalog of contracts, properly loading all contracts into required systems/vendors, and delivering new vendor/provider onboarding
• Support Operations, IT, Finance and other key departments with procurement, vendor management and tracking of various contract types
• Co-lead regular reviews with the Quality & Compliance Director Improvement Manager/Compliance Officer to coordinate quality assessment of providers including onsite visits of providers
• Ensures that applicable websites are monitored monthly and as needed for disciplinary summaries from the Board of Medical Examiners, as well as excluded providers from Medicare and Medicaid (OIG)
• Collaborate with the central and local owners of the vendor relationship and support in ongoing monitoring of vendor performance as needed.
• Implement a regular standing meeting with key contract owners at the time of renewal to evaluate performance and contract continuance.
• Develop structure for contract repository system to manage that all executed agreements with quality controls in place to ensure all contracts are up to date and tracked.
• Collaborate with Quality and Health Plan Compliance teams as needed for any related Fraud, Waste & Abuse (FWA) tracking of vendors/providers
• Manage and provide oversight to selected other external vendors related to any of the functions listed above and more, ensuring quality and adherence to protocols
• Develop policies and procedures that meet applicable PACE program requirements
• Stay current on regulations and policies impacting the PACE program, health plan operations, and our compliance program and share that knowledge across the organization 
• Assist the company in ad hoc special projects, including collaborations with external partners, vendor contracting, and other operating model decisions 
• Continuously seek improvements to processes and systems across functions as the size and complexity of our business grows
• Communicate confidently and persuasively to all audiences, including external stakeholders

• Passion and mission orientation for serving high-risk seniors and frail older adults
• Strong understanding of health plan, healthcare provider & vendor contracting and regulatory requirements, ideally in a PACE, Medicare Advantage (MAPD), or Medicare Prescription Drug Plan (PDP) organization
• Thrives in a relatively undefined, “zero to one” environment – unafraid to “roll up your sleeves” and drive a wide-ranging set of projects, processes, and deliverables
• Preferred 5+ years of related experience in a similar role and education concentration (e.g., certification, Bachelor’s, or Master’s) in a related field (e.g., business, legal, healthcare administration/MHA, etc.)   
• Experience in corporate health plan, venture-backed startups, private equity, investment banking, or other finance-focused roles in high-growth and entrepreneurial environments
• Meticulous attention to detail – ability to review contracts for discrepancies
• An independent worker who can run down problems with relatively little direction, knows when and how to escalate effectively  
• Prior experience building from the ground up or scaling a provider network or contract management function at a high-growth healthcare organization preferred
• Expert proficiency in both MS Excel and PowerPoint required

• Based in Los Angeles in a hybrid onsite/remote capacity, with ability to travel (mainly locally) up to 50% based on business need
• We anticipate this role will be onsite up to 10 days per month. 

Your Application

Please submit your resume/CV and a short message that explains why you are interested in this role.

Our Commitment to Diversity, Equity and Inclusion

At myPlace Health, we value the diversity of our team members, and we are committed to building a culture of inclusion and belonging.  We pride ourselves to be an equal opportunity employer.  People seeking employment at myPlace Health are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.

COVID-19 Vaccination Policy

At myPlace Health, we provide safe and high-quality care to our participants. To achieve this, we have implemented a strongly recommended vaccination policy to keep both our team members and participants safe as an essential requirement of this role. Medical and religious exemptions can be granted based upon review of proper documentation. We adhere to all federal, state, and local regulations by obtaining necessary proof of vaccination prior to employment.

Beware of Scams and Fraud

Please beware of scams that solicit interviews or promote jobs for opportunities that are not listed on our website or are not directly related to a job you applied for yourself. Please be advised that myPlace Health will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission by selecting the ‘Rip-offs and Imposter Scams’ option: https://reportfraud.ftc.gov/#/