Director, Vendor Management

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

Brighton One 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.

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.

• 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.

• 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.

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

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

• 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.

• 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.

• 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, Health Rules, 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.

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

Some elements of the job are sedentary, but the employee will be required to…