VENDOR MANAGEMENT ANALYST

Pearson; Salem (OR); Remote; USD 50,000 - 91,000; Full time

Job summary

A leading education company is seeking a Medicaid and Vendor Implementation Manager to streamline Medicaid processes and manage vendor relationships for virtual school services. This remote role focuses on compliance, data management, and developing policies to optimize reimbursement processes. The ideal candidate will possess a Bachelor's degree and relevant experience in Medicaid and vendor management.

Qualifications

• Experience in Medicaid reimbursement and vendor relationship management.
• Strong understanding of federal and state Medicaid regulations.
• Proven ability to manage complex reimbursement systems.

Responsibilities

• Act as a liaison with third-party service providers for Medicaid processes.
• Ensure compliance with Medicaid billing guidelines.
• Collaborate with vendors and maintain comprehensive documentation.

Skills

Medicaid reimbursement

Vendor management

Compliance

Data management

Customer service

Training

Education

Bachelor’s degree in Finance, Education, Business Administration or related field

Tools

Medicaid billing software

Microsoft Office Suite

Job description

1 week ago Be among the first 25 applicants

Location : Remote

At Pearson, we’re committed to a world that’s always learning and to our talented team who makes it all possible. We are bold thinkers and standout innovators who push the boundaries of technology. We create seeds of learning that become the catalyst for the world’s innovations. Within the Pearson Virtual Schools (PVS) division we have reimagined K-12 education through our virtual school and curriculum offerings. Our schools, Connections Academy and Pearson Online Academy, provide a best-in-class online learning environment for K-12 students to acquire the skills and confidence they need to adapt and thrive in a changing world. We also support school districts with curriculum, teachers, and technology as they make the shift to online. The COVID-19 pandemic introduced significant disruption and transformation to the K-12 learning market. And as a result, our category has seen explosive growth and our business has experienced enormous increases in awareness and enrollments. This presents an incredible opportunity for our team to chart a ground-breaking path through this shifting environment to achieve continued success.

Purpose Summary

The Medicaid and Vendor Implementation Manager will act as the main liaison, fostering robust relationships with third-party service providers, including related services, Medicaid, IEP, translation, assistive technology, and sign language vendors, on behalf of Connections Academy schools. The individual in this role will assist in developing, implementing, and overseeing Medicaid reimbursement processes for all applicable Pearson Virtual Schools Connections Academy programs. Responsibilities include ensuring compliance with federal and state Medicaid regulations, optimizing funding mechanisms, facilitating the smooth onboarding of third-party staff, and addressing customer concerns related to vendors.

• Medicaid Reimbursement Framework Support o Assist in establishing a standardized Medicaid reimbursement framework for all Connections Academy schools.
• Collaborate with Medicaid vendors to comprehend specific regulations and requirements pertinent to virtual school services.
• Develop policies and procedures to guarantee compliance with Medicaid billing guidelines and eligibility criteria.
• Act as the primary point of contact for vendors, including third-party staffing agencies and product providers.
• Maintain comprehensive records and documentation for vendors and third-party staff in a centralized database.
• Contribute to the development, training, and enforcement of standards and expectations for vendors and third-party staff.
• Create and manage customer-facing resources to streamline third-party staffing processes at Connections Academy schools.
• Data Management and Reporting
• Implement data collection processes to ensure accurate tracking of Medicaid-eligible services.
• Monitor claims submissions to ensure they are accurate and submitted in a timely manner.
• Generate comprehensive reports to analyze reimbursement trends and identify opportunities for improvement.
• Stakeholder Collaboration and Training
• Collaborate with internal and external stakeholders as needed to ensure excellent services.
• Provide training to internal staff on Medicaid billing, documentation, and compliance requirements as needed.
• Serve as the primary contact for internal and external Medicaid audits, ensuring readiness and compliance.
• Facilitate the comprehensive operational implementation of third-party products, ensuring a smooth onboarding process for third-party staff.
• Monitor implementation milestones and address any issues to maintain customer satisfaction.
• Assist in gathering insights from customers and vendors to develop effective implementation plans and complete operational tasks.

Location : Remote

At Pearson, we’re committed to a world that’s always learning and to our talented team who makes it all possible. We are bold thinkers and standout innovators who push the boundaries of technology. We create seeds of learning that become the catalyst for the world’s innovations. Within the Pearson Virtual Schools (PVS) division we have reimagined K-12 education through our virtual school and curriculum offerings. Our schools, Connections Academy and Pearson Online Academy, provide a best-in-class online learning environment for K-12 students to acquire the skills and confidence they need to adapt and thrive in a changing world. We also support school districts with curriculum, teachers, and technology as they make the shift to online. The COVID-19 pandemic introduced significant disruption and transformation to the K-12 learning market. And as a result, our category has seen explosive growth and our business has experienced enormous increases in awareness and enrollments. This presents an incredible opportunity for our team to chart a ground-breaking path through this shifting environment to achieve continued success.

Purpose Summary

The Medicaid and Vendor Implementation Manager will act as the main liaison, fostering robust relationships with third-party service providers, including related services, Medicaid, IEP, translation, assistive technology, and sign language vendors, on behalf of Connections Academy schools. The individual in this role will assist in developing, implementing, and overseeing Medicaid reimbursement processes for all applicable Pearson Virtual Schools Connections Academy programs. Responsibilities include ensuring compliance with federal and state Medicaid regulations, optimizing funding mechanisms, facilitating the smooth onboarding of third-party staff, and addressing customer concerns related to vendors.

Core Tasks And Responsibilities

• Medicaid Reimbursement Framework Support o Assist in establishing a standardized Medicaid reimbursement framework for all Connections Academy schools.
• Collaborate with Medicaid vendors to comprehend specific regulations and requirements pertinent to virtual school services.
• Develop policies and procedures to guarantee compliance with Medicaid billing guidelines and eligibility criteria.
• Act as the primary point of contact for vendors, including third-party staffing agencies and product providers.
• Maintain comprehensive records and documentation for vendors and third-party staff in a centralized database.
• Contribute to the development, training, and enforcement of standards and expectations for vendors and third-party staff.
• Create and manage customer-facing resources to streamline third-party staffing processes at Connections Academy schools.
• Data Management and Reporting
• Implement data collection processes to ensure accurate tracking of Medicaid-eligible services.
• Monitor claims submissions to ensure they are accurate and submitted in a timely manner.
• Generate comprehensive reports to analyze reimbursement trends and identify opportunities for improvement.
• Stakeholder Collaboration and Training
• Collaborate with internal and external stakeholders as needed to ensure excellent services.
• Provide training to internal staff on Medicaid billing, documentation, and compliance requirements as needed.
• Serve as the primary contact for internal and external Medicaid audits, ensuring readiness and compliance.
• Facilitate the comprehensive operational implementation of third-party products, ensuring a smooth onboarding process for third-party staff.
• Monitor implementation milestones and address any issues to maintain customer satisfaction.
• Assist in gathering insights from customers and vendors to develop effective implementation plans and complete operational tasks.

Required Skills, Experience, And Competencies

• Bachelor’s degree in Finance, Education, Business Administration, or a related field, or equivalent experience in Medicaid reimbursement, vendor management, and program management.
• Experience in Medicaid reimbursement and vendor relationship management, preferably within educational or virtual school environments.
• Strong understanding of federal and state Medicaid regulations.
• Proven ability to manage complex reimbursement systems, compliance programs, and vendor relationships effectively.
• Excellent organizational, analytical, and communication skills.
• Proficiency in Medicaid billing software, data management systems, and Microsoft Office Suite.
• Demonstrated track record of providing outstanding customer service and collaborating effectively in a fast-paced environment.
• This position plays a critical role in ensuring Pearson Virtual Schools leverage Medicaid funding effectively to enhance student services, while also managing strong relationships with third-party staffing agencies and product vendors.

Key relationships

• Works closely with the Senior Operations Manager and the Operations Team to ensure efficient execution of initiatives and operational excellence.
• Maintains positive and collaborative relationships with Student Services Specialists and school staff to support their needs effectively.
• Cultivates and sustains strong partnerships with third-party vendors, ensuring clear communication and mutual support.
• Engages with various internal stakeholders to facilitate cooperation across departments and enhance overall operational effectiveness.

1106896

Job Family : GENERAL BUSINESS OPERATIONS

Schedule : FULL_TIME

location

Seniority level

Seniority level

Not Applicable

Employment type

Employment type

Full-time

Job function

Job function

Business Development and Sales

Education Administration Programs and E-Learning Providers

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