Clinical Vendor Governance – Program Manager

Clinical Vendor Governance -- Program Manager

Job Title: Program Manager -- Clinical Vendor Governance / Red Flag Review Council

Employment Type: Contract / Contingent

Location: Remote within the U.S.

Work Hours: Primarily U.S. Central Time business hours

Location Preference: Hartford, CT preferred

Experience: 7 years

Engagement: Contract

Position Overview

We are seeking an experienced Program Manager -- Clinical Vendor Governance to establish and manage a structured governance process for clinical vendors and provider organizations requiring elevated review.

The Program Manager will run the operating engine of the Clinical Vendor Red Flag Review Council
, managing the complete governance lifecycle including case intake, readiness validation, agenda development, executive preparation, meeting coordination, decision documentation, action tracking, and follow-through to closure.

This is an internally focused role requiring close collaboration with Clinical Vendor Solutions & Management, Network Operations, Contracting, Medical Affairs, Legal, SIU, Payment Integrity, Compliance, and senior leadership
.

The successful candidate will be comfortable working with senior executives, consolidating complex information, preparing executive-ready materials, driving accountability, and keeping multiple work streams moving to completion.

Key Responsibilities

• Own the monthly council calendar, meeting invitations, scheduling, and ad hoc sessions.

• Develop and publish meeting agendas in partnership with the Council Chair.

• Prioritize cases based on urgency, risk exposure, and decision readiness.

• Prepare and distribute executive-level pre-read materials.

• Support meeting facilitation by managing time, agenda flow, and unresolved issues.

• Capture decisions, rationale, conditions, dissent, owners, and next steps.

• Publish post-council meeting recaps and action items.

• Manage intake for vendors and provider organizations escalated for governance review.

• Validate cases for required business, financial, utilization, contractual, legal, network, medical policy, SIU, and compliance information.

• Identify and close information gaps before cases are presented to senior leadership.

• Prepare standardized case packages containing:

• Vendor/provider profile

• Reason for escalation

• Key findings

• Risk assessment

• Options considered

• Recommended action

• Prepare Council Chair and presenters for anticipated questions and decision points.

• Maintain a prioritized pipeline of vendors under review, on watch lists, and pending reassessment.

• Maintain the master action log with owners, deadlines, dependencies, and status.

• Drive corrective actions and follow-up activities through completion.

• Track governance holds, contracting restrictions, renegotiation activities, termination work streams, and legal actions.

• Confirm closure of decisions and downstream activities with accountable owners.

• Manage the council workplan using Asana or comparable work management tools
  .

• Provide recurring status reports covering pipeline, decisions, open actions, aging items, and risks.

• Identify process gaps and recommend improvements to governance workflows.

• Serve as the primary coordination point for senior stakeholders across multiple business functions.

• Coordinate with Executive Directors, AVPs, VPs, and other senior leaders.

• Manage stakeholder engagement between council meetings.

• Conduct pre-alignment discussions and coordinate data/information requests.

• Prepare executive-ready presentations, decision memoranda, escalation briefs, and summaries.

• Coordinate with Legal on authorized formal communications.

• Escalate matters requiring executive decisions with a clear summary of the issue, available options, and recommendation.

• Maintain comprehensive council decision records.

• Develop and maintain templates for case packages, pre-reads, meeting recaps, and decision documentation.

• Maintain the SharePoint site and council resource library.

• Document standard operating procedures and governance processes.

• Ensure records are organized, retrievable, and suitable for audit, compliance, and legal requirements.

Required Qualifications

• 7 years of experience in Program Management, Project Management, Chief of Staff, or a similar role.

• Experience directly supporting executive-level governance forums, councils, or decision committees
  .

• Proven experience preparing, facilitating, and documenting meetings involving senior…