Director, Vendor Performance Management

BrightonOne; Boston (MA); On-site; USD 140,000 - 170,000; Full time

Job summary

BrightonOne in Boston-area is seeking a Director, Vendor Performance Management to lead USFHP's oversight of third-party vendors, focusing on claims and core operations. The role is hybrid—four days in Brighton, MA and one day remote; it is an exempt position.

You will own vendor governance end-to-end, manage SLAs and scorecards, and drive audits, CAPs, and remediation. You will partner with operations, compliance, finance, and clinical teams, reporting to leadership and governance committees.

Qualifications

• Bachelor's degree required; Master's preferred.
• 10+ years of vendor management, delegation oversight, claims operations, or health plan operations with leadership experience.
• Experience with claims and delegated-vendor oversight in managed care; government-program experience preferred.

Responsibilities

• Own the vendor management framework, including due diligence, onboarding, delegation agreements, and audits.
• Maintain delegation oversight per contractual and accreditation requirements (NCQA/URAC).
• Manage vendor inventory, risk tiering, and oversight calendar.

Skills

Vendor governance

SLA management

Cross‑functional leadership

Regulatory compliance

Vendor risk assessment

Education

Bachelor's degree

Master's degree

Tools

Facets

QNXT

HealthRules

Job description

Title: Director, Vendor Performance Management

Job Type: Full-time

Location: Hybrid - 4 days per week in Brighton, MA office; 1 day remote

FLSA Status: Exempt

About Us

BrightonOne is a nonprofit social enterprise delivering healthcare, housing, and hope to veterans and military-connected families, with enterprise discipline in service to those who served.

Position Overview

The Director, Vendor Performance Management leads USFHP's oversight of third-party vendors and delegated functions, with particular focus on claims and other core operational vendors. The Director owns the vendor governance framework end to end — delegation oversight, SLA and performance management, audits, and remediation — ensuring vendors meet contractual, regulatory (TRICARE/USFHP, DHA), and quality obligations. The Director partners across operations, compliance, finance, and clinical teams and reports vendor performance and risk to leadership and governance committees.

Key Responsibilities

Vendor Governance & Delegation Oversight

• Own the vendor management framework, including due diligence, onboarding, delegation agreements, and pre-delegation and annual delegation audits.
• Maintain delegation oversight consistent with contractual and accreditation (NCQA/URAC) requirements, including reporting and evidence.
• Manage the vendor inventory, risk tiering, and oversight calendar.

SLA & Performance Management

• Establish and manage SLAs, performance standards, and scorecards across claims and operational vendors.
• Conduct regular business reviews; monitor performance, identify gaps, and drive data-based accountability.
• Lead root-cause analysis, corrective action plans (CAPs), and remediation for underperformance, with escalation and, where needed, penalty/exit provisions.

Claims & Operational Vendor Oversight

• Oversee claims vendor performance, including accuracy, timeliness, financial performance, and compliance.
• Partner with technical SMEs on claims configuration, testing, and issue resolution.

Compliance & Reporting

• Ensure vendor oversight meets TRICARE/USFHP, DHA, HIPAA, and accreditation requirements.
• Report vendor performance, risk, and remediation status to leadership and governance committees.

Leadership & Team Management

• Lead, coach, and develop the vendor performance management team; partner with Human Resources on hiring and development.
• Partner with operations, compliance, finance, and clinical teams on vendor strategy and contracting.

Requirements

Qualifications

Education & Experience

• Bachelor's degree required; Master's degree preferred.
• 10 or more years of vendor management, delegation oversight, claims operations, or health plan operations experience, including leadership.
• Experience with claims and delegated-vendor oversight in managed care; government-program experience preferred.

Skills & Competencies

• Deep expertise in vendor/delegation oversight, SLA and contract management, and claims operations.
• Strong analytical, negotiation, and performance-management capabilities.
• Leadership, cross-functional collaboration, and vendor-relationship management skills.
• Excellent communication and collaboration with technical subject-matter experts and vendors.
• Proficiency in Microsoft Office Suite and platforms such as Facets, QNXT, HealthRules, or similar systems.
• Familiarity with CMS, URAC, NCQA, TRICARE, and healthcare regulatory requirements.
• Familiarity with CAQH, NPPES, PECOS, and provider credentialing databases.
• Experience with Medicare, TRICARE, managed care, or government-sponsored health programs preferred.

Other Requirements

• Must be able to obtain and maintain U.S. Government personnel security clearance as a condition of employment.

Physical Nature of the Job

Some elements of the job are sedentary, but the employee will be required to stand for periods of time or move throughout the campus.

Equal Opportunity Employer Statement

BrightonOne is an Equal Opportunity Employer. We prohibit discrimination and harassment of any kind based on race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, genetic information, protected veteran status, or any other characteristic protected by federal, state, or local law. We strongly encourage applications from veterans and individuals with disabilities. Accommodations are available upon request for candidates taking part in all aspects of the selection process.

Work Authorization

Candidates must be authorized to work in the United States without sponsorship now or in the future.