Quantum Health Careers

Who we are

Founded in 1999 and headquartered in Central Ohio, we’re a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective for our millions of members. Our big-hearted, tech-savvy team fights to ensure that our members get the care they need, when they need it, at the most affordable cost – that’s why we call ourselves Healthcare Warriors®.

We’re committed to building diverse and inclusive teams – more than 2,000 of us and counting – so if you’re excited about this position, we encourage you to apply – even if your experience doesn’t match every requirement.

About the role

The Clinical Vendor Program Manager leads the strategic direction, selection, and performance management of clinical and pharmacy vendors ensuring strategic alignment with enterprise growth and client objectives.  This role provides executive-level consultation on vendor strategy, and drives vendor selection, contract negotiation, performance oversight, and risk management. Serves as the primary interface between clinical program/strategy and other internal and external stakeholders to maintain a multi- and inter-disciplinary vendor project coordination. The ideal candidate brings expertise in healthcare operations, vendor partnerships, and regulatory compliance to optimize the efficiency and effectiveness of vendor program offerings.

Location: This position is located at our Dublin, OH campus with hybrid flexibility or This position may work remotely anywhere in the United States of America.

What you’ll do (Essential Responsibilities)

Vendor Strategy & Selection:

Shapes the enterprise's preferred partnership strategy roadmap to align with corporate growth objectives and emerging healthcare market trends.

Proactively identify, evaluate, and onboard clinical vendors that align with population data insights and market demands. Directs and assists leadership in deciding whether to add, replace, or terminate a service line to ensure current offerings support organizational and clients' needs.

Develop and maintain a comprehensive multi-year roadmap including areas of exploration and implementation targets.

Ensure alignment with organizational and clinical and market strategies, ensuring quality, cost-effectiveness, and compliance.

Lead contract negotiations by establishing service level agreements (SLAs) and performance guarantees (PGs) to ensure cost-effective vendor partnerships while maintaining high-quality service delivery. Develop, in conjunction with Finance, the revenue model. Creates and finalizes all Program Descriptions and Order Forms for market launch and ongoing maintenance.

Performance Monitoring & Optimization:

Develop and implement key performance indicators (KPIs) and benchmarks to assess vendor performance, drive accountability, and ensure project goals for data integration, engagement, and clinical outcomes are achieved.

Proactively identify and address vendor-related challenges, ensuring seamless operations and alignment with organizational and client objectives. Monitor contract terms and conduct proper oversight.

Identify and implement opportunities to enhance vendor management processes, streamline workflows, and improve efficiency in clinical service delivery. Oversight of external and internally sourced data management to include vendor reports to ensure reporting supports clinical strategy and messaging.

Draft the development of technical business requirements for project success. This includes defining project objectives, expected outcomes, resource requirements, and evaluation strategies to ensure vendor program effectiveness.

Stakeholder Collaboration:

Maintains regular communication with clinical vendors as the primary interface and business owner to review their strategic roadmaps and integration capabilities and develop joint operating committee infrastructure with vendors to regularly evaluate performance and drive vendor expectations.

Partner with sales, technical, legal, procurement, and finance teams to optimize vendor strategies and integration within systems that support and align with clinical strategies.

Present data and information to internal and external stakeholders by applying clinical knowledge and the use of healthcare data to drive decisions to help organizational leaders understand the clinical impact of these solutions. Serves as a subject matter expert with key clients, driving consultative discussions to influence adoption and retention of clinical vendor solutions.

Partner with sales and marketing to conduct joint marketing engagement opportunities with clients and vendors. This may include marketing campaigns and vendor summits.

Partner with training to drive organizational awareness of clinical vendors to drive engagement and effectiveness of vendor solutions.

Risk & Compliance Management:

Accountable for vendor compliance with regulatory requirements (e.g., CMS, HIPAA, NCQA, URAC as applicable) and internal policies to mitigate potential risks within the payer environment.

Business owner to ensure appropriate contracts in place (e.g., BAA, NDA, and Service Agreements). Directs contracting with accountability for service level agreements (SLAs), performance guarantees (PGs), and financial impact.

Oversees vendor compliance with all contract provisions.

Report to legal and risk any potential compliance or regulatory issues.

All other duties as assigned.

What you’ll bring (Qualifications)

Education: Bachelor’s degree in Health Administration or a health-related field that delivers a strong clinical knowledge base. Master’s preferred.

Experience: Minimum 3-5 years of experience in vendor management within a payer, medical management, or healthcare operations environment.

Proven track record of managing multimillion-dollar vendor portfolios.

Licenses & Certifications (Preferred): RN licensure preferred.

If licensed, must hold an active, unrestricted, and unencumbered professional license in good standing with the state board of licensure in one of the applicable clinical disciplines: Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Pharmacist (PharmD), or other licensed healthcare professional authorized to conduct an assessment independently.  Where applicable, clinicians must hold a Multi-State License (MSL) issued through the relevant licensure compact (e.g., Nurse Licensure Compact for RNs). For clinicians in states that do not offer MSL, or for disciplines for which an MSL program has not been launched, employees must be willing and able to obtain and maintain additional state licenses as required to support members served by the organization. Both the MSL and individual state licenses must be obtained within 90 days of hire. Maintenance of required licensure, including timely renewal and compliance with state board regulations, is a condition of employment. 

Certification in Case Management (e.g., CCM), Healthcare Management (e.g., CPHQ, CHC), or Procurement (e.g., CPSM) is advantageous.

Proven ability to negotiate contracts and manage relationships with clinical solution vendors.

Strong analytical skills with the ability to interpret complex clinical data and translate it into presentations and actionable insights. Excellent problem-solving and decision-making skills.

Exceptional presentation and communication skills, with experience presenting to clients.

Ability to work collaboratively with cross-functional teams and external clients and consultants.

Strong organizational skills and the ability to manage multiple projects simultaneously.

Experience with budget forecasting and financial oversight of vendor contracts.

Experience managing clinical technology solutions or care management platforms in a medical management environment.

Strong understanding of medical management/clinical operations, clinical programs, and regulatory requirements.

Proficiency in vendor management software and payer-related systems is a plus.

A high degree of personal accountability and trustworthiness, a commitment to working within Quantum Health’s policies, values and ethics, and to protecting the sensitive data entrusted to us.

#LI-HW1

#LI--Remote