Vendor Performance & Claims Expert (Hybrid)

BrightonOne; Boston (MA); Hybrid; USD 110,000 - 140,000; Full time

Benefits offered by this job

Security clearance eligibility

Job summary

BrightonOne is a nonprofit social enterprise delivering healthcare, housing, and hope to veterans and military-connected families. The Senior Specialist, Vendor Performance Management, will oversee USFHP vendors, drive accountability on SLAs, and provide claims-process subject-matter expertise to ensure timely, accurate, and compliant service.

You will collaborate with operations, compliance, and finance teams, prepare vendor performance reports, and participate in governance activities.

Qualifications

• Bachelor's degree preferred, or equivalent experience.
• 4+ years in vendor management, claims operations, or health plan operations.
• Subject-matter expertise in claims processing and vendor/SLA management preferred.
• Proven analytical and collaborative skills with stakeholders.

Responsibilities

• Oversee vendor relationships and monitor SLAs and scorecards.
• Develop and enforce vendor accountability plans and corrective actions.
• Analyze claims data to identify issues and drive remediation.

Skills

Vendor management

Claims operations

SLA management

Analytical skills

Communication

Education

Bachelor's degree or equivalent

Experience in health plans

Tools

Facets

QNXT

HealthRules

MS Office

Job description

BrightonOne is a nonprofit social enterprise delivering healthcare, housing, and hope to veterans and military-connected families. The Senior Specialist, Vendor Performance Management, will oversee USFHP vendors, drive accountability on SLAs, and provide claims-process subject-matter expertise to ensure timely, accurate, and compliant service.

You will collaborate with operations, compliance, and finance teams, prepare vendor performance reports, and participate in governance activities.