Clinical nurse specialist Jobs in Cleveland, OH

Medical Mutual employees must submit their applications through MySource.

This is a hybrid‐remote role based out of the Brooklyn, OH office, with employees expected to work onsite on designated in‐office days each week.

Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.

Clinical Vendor Partnerships Specialist I

Job Summary:

Supports the development and maintenance of long-term relationships with clinical vendors. Collaborates with team to understand capabilities, gather information and data needed for contracts, amendments, and scorecards. Drives completion of deliverables with business teams and clinical vendors to meet established timelines, quality commitments, and other performance objectives.

Responsibilities:

• Supports the development and maintenance of relationships with clinical vendors and collaborates with team to understand capabilities.
• Follows established processes to gather information and data needed to prepare for weekly, monthly, and ad hoc meetings with vendors to ensure alignment on performance expectations, and continuous improvement/innovation strategies.
• Assists with vendor performance reviews, invoice reconciliation, and documents discrepancies.
• Assesses and escalates risks associated with clinical vendors throughout the contract cycle.
• Performs other duties as assigned.

Qualifications:

Education and Experience:

• Bachelor's degree in business/health administration, finance, accounting, or related field. In lieu of degree, may consider equivalent combination of education/training and experience.
• Up to 1 year experience or academic project work in vendor/relationship management, procurement, or related role preferably in a health plan or health care setting.

Professional Certification(s):

• Project Management or other industry recognized certification a plus.

Technical Skills and Knowledge:

• Fundamental understanding of relationship and project management.
• Basic task management and time management skills
• Clear and concise oral and written communication skills and ability to create simple presentations.
• Basic knowledge of negotiating and writing contracts, amendments, and service level agreements.
• Basic to intermediate Microsoft Office Suite (Word, PowerPoint, Excel) skills. Basic knowledge of data/vendor management systems and ability to develop proficiency.

Clinical Vendor Partnerships Specialist II

Job Summary:

Develops and maintains long-term relationships with clinical vendors. Understands capabilities, negotiates contracts and amendments collaboratively, and ensures timely delivery of high-quality products and services. Serves as the liaison between the clinical businesses and external clinical vendors to meet performance objectives.

Responsibilities:

• Builds and maintains relationships with clinical vendors, understands their capabilities and creates tailored solutions to meet business needs.
• Prepares and leads weekly, monthly, and ad hoc meetings with vendor to ensure alignment on performance expectations.
• Reviews vendor performance reports, conducts invoice reviews to reconcile discrepancies and identify issues, proposes solutions, and escalates issues to senior leadership as needed.
• Acts as the single point of contact for clinical business units and clinical vendors, addresses inquiries and resolves issues.
• Collaborates cross functionally to source, implement, and monitor performance to ensure contractual service levels are met or exceeded.
• Proactively identifies and mitigates risks associated with clinical vendors throughout the contract cycle.
• Performs other duties as assigned.

Qualifications:

Education and Experience:

• Bachelor's degree in business/health administration, finance, accounting, or related field. In lieu of degree, may consider equivalent combination of education/training and experience.
• 3+ years of experience as a Clinical Vendor Partnerships Specialist or equivalent proven experience in vendor/relationship management, procurement, or related role, preferably in a health plan or health care setting.

Professional Certification(s):

• Project Management or other industry recognized certification a plus.

Technical Skills and Knowledge:

• Good business partnership and project management skills.
• Good analytical skills to assess vendor performance and key performance indicators.
• Good written and oral communication and presentation skills.
• Knowledge of negotiating and writing contracts, amendments, and service level agreements.
• Intermediate skills with Microsoft Office Suite (Word, PowerPoint, Excel) and data management tools (QuickBase or similar), and vendor management systems.

Sr. Clinical Vendor Partnerships Specialist

Job Summary:

Builds and sustains long-term partnerships with key clinical vendors, overseeing substantial financial investments. Understands vendor capabilities, negotiates contracts and amendments collaboratively, and ensures the timely delivery of high-quality products and services. Acts as a strategic partner to clinical businesses and vendors, tailoring solutions to align with company objectives.

Responsibilities:

• Creates and maintains relationships with clinical vendors, understands their capabilities and creates tailored solutions to meet business needs.
• Acts as the single point of contact for clinical business units and key clinical vendors, addresses inquiries and resolves issues.
• Oversees vendor performance reports and invoice reviews to reconcile discrepancies and identify issues, proposes solutions, and escalates issues to senior leadership as needed.
• Prepares and leads weekly, monthly, and ad hoc meetings with vendor to ensure alignment on performance expectations, improvement opportunities, and future innovation strategies.
• Collaborates cross functionally to source, implement, and monitor performance to ensure contractual service levels are met or exceeded. Executes corrective action plans when appropriate.
• Proactively identifies and mitigates risks associated with clinical vendors throughout the contract cycle.
• Orients, trains, assists and reviews work of more junior level staff.
• Performs other duties as assigned.

Qualifications:

Education and Experience:

• Bachelor's degree in business/health administration, finance, accounting, or related field. In lieu of degree, may consider equivalent combination of education/training and experience.
• 5+ years of progressive experience as a Clinical Vendor Partnerships Specialist or equivalent proven experience in vendor/relationship management, procurement, or related role, preferably in a health plan or health care setting.

Professional Certification(s):

• Project Management or other industry recognized certification preferred.

Technical Skills and Knowledge:

• Excellent business partnership skills and ability to manage multiple projects simultaneously, ensuring timely delivery and adherence to budget.
• Strong analytical skills to assess vendor performance and market trends.
• Excellent written and oral communication and presentation skills.
• Expertise in negotiating and writing contracts, amendments, and clearly defined service level agreements.
• Proficient in Microsoft Office Suite (Word, PowerPoint, Excel) and data management tools (QuickBase or similar), and vendor management systems.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:

A Great Place to Work:

• We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
• Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
• On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
• Discounts at many places in and around town, just for being a Medical Mutual team member.
• The opportunity to earn cash rewards for shopping with our customers.
• Business casual attire, including jeans.

Excellent Benefits and Compensation:

• Employee bonus program.
• 401(k) with company match up to 4% and an additional company contribution.
• Health Savings Account with a company matching contribution.
• Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
• Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
• Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
• After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

• Career development programs and classes.
• Mentoring and coaching to help you advance in your career.
• Tuition reimbursement up to $5,250 per year, the IRS maximum.
• Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutual's status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

There's a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

We're not just one of the largest health insurance companies based in Ohio, we're also the longest running. Founded in 1934, we're proud of our rich history with the communities where we live and work.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.

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