HMSA

Category Manager, Healthcare Operations

HMSA  •  Honolulu, HI (Hybrid)  •  21 hours ago
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Job Description

  1. Category Strategy and Planning
    • Partner with the Chief Procurement Officer (CPO) and operations leadership to develop multi-year category strategies for Healthcare operations vendors.
    • Lead execution of operations vendor strategy, ensuring alignment with enterprise architecture, digital transformation, and cybersecurity priorities.
    • Coordinate with operations leadership on vendor demand planning, technology roadmaps, product lifecycles, and modernization efforts.
    • Conduct market research and stay up to date with current trends across operational vendors and products.
    • Identify cost optimization, rationalization, standardization, and risk mitigation opportunities.
  2. Strategic Sourcing and Contracting
    • Lead sourcing, competitive events (RFx), and negotiation of complex healthcare operations contracts ($1M-$5M+) including requirements definition, supplier evaluation, and award recommendations.
    • Structure and negotiate commercial terms (PMPY, tiered pricing, FTE-based, shared savings, performance-based models).
    • Ensure strong contractual language including SLAs, KPIs, auditing, data privacy, regulatory compliance, etc.
    • Drive renewals, amendments, and re-negotiations to optimize total cost of ownership.
  3. Vendor Governance and Performance Oversight
    • Provide vendor oversight for Health Operations suppliers, owning commercial performance of vendors, including cost, value realization, and contract adherence.
    • Partner with business owners and/or vendor managers to ensure alignment between financial outcomes and operational performance.
    • Partner with Vendor Managers and Health Operations owners to ensure governance, QBRs, continuous improvement, and issue resolution.
    • Support privacy, cybersecurity, third‑party risk, and regulatory compliance assessments.
    •  Identify opportunities for cost recovery, demand management, and contract re-baselining.
  4. Financial and Value Management
    • Analyze health operations vendor spend and utilization trends to identify savings opportunities; deliver and track quantifiable cost savings, cost avoidance, and value creation across health operations spend.
    • Validate pricing structures and ensure invoice accuracy and budget impacts.
    • Develop business cases for contract decisions, sourcing decisions, vendor consolidations, and vendor transitions.
    • Support medical cost containment initiatives, budget cycles, forecasting, and health operations investment planning.
  5. Stakeholder and Cross-Departmental Collaboration
    • Serve as strategic advisor to healthcare operations leadership.
    • Partner with Legal, Compliance, Finance, IT, and Risk Management throughout sourcing lifecycle.
    • Educate business stakeholders on procurement governance, contract requirements, vendor best practices, and policy.
    • Influence stakeholders toward enterprise-aligned vendor decisions.
  6. Performs all other miscellaneous responsibilities and duties as assigned or directed.
 
 
#LI-Hybrid
Qualifications
  1. Bachelor's degree in Supply Chain, Healthcare Administration, Finance, or related field; or equivalent combination of education and experience.
  2. Seven years of progressive experience in procurement, category management, or vendor management.
  3. Experience negotiating mid-to-large operational service agreements.
  4. Experience with IT ecosystems, including cloud platforms (AWS, Azure), workflow tools (ServiceNow), managed service vendors (i.e., claims/process outsourcing environments), care management systems and payor platforms, and member portals and digital engagement systems.
  5. Experience supporting IT service lifecycle, including renewals, vendor transitions, and system implementations.
  6. Strong understanding of core healthcare operations domains such as claims, enrollment, member services, care management, call center, clinical vendors, etc.).
  7. Strong familiarity with operational sourcing, procurement best practices, and vendor selection processes.
  8. Ability to collaborate effectively across teams.
  9. Strong analytical, problem‑solving, commercial negotiation, and financial modeling capabilities tailored for operations environments.
  10. Familiarity with IT service management or ticketing tools and basic understanding of how IT workflow systems operate.
  11. Ability to analyze data exports from IT vendors, cloud platforms, licensing portals, or SaaS management tools.
  12. Strong understanding of legal and commercial contract terms.
  13. Demonstrate experience in healthcare operations or healthcare payor environment.
  14. Demonstrated ability to drive measurable savings and commercial outcomes.
  15. Ability to interpret complex requirements, operational dependencies, and contract cost structures.
  16. Ability to interpret technical requirements, architecture dependencies, and IT cost structures.
  17. Advanced knowledge in Microsoft Office Suite, including the ability to build and interpret Excel models for healthcare operations spend, licensing, and forecasting.
  18. Ability to work with procurement and contract management systems for contract lifecycle activities (e.g., Source to Pay, ERP, etc.).
  19. Familiarity with service management or ticketing tools and basic understanding of how procurement workflow systems operate.
  20. Familiarity with contract management or procurement workflow tools.
  21. Ability to analyze data exports from vendor systems or procurement platforms.

**Hybrid Work Environment - Must reside in Hawaii**
 
Pay Range: $78,000 - $153,000
 
Note: Individuals typically begin between the minimum to middle of the pay range
 
The procurement Category Manager for Healthcare Operations is responsible for developing and executing category strategies for healthcare operations and core service vendors that directly impact medical cost, operational performance, and member experience.
 
This role leads end to end sourcing, negotiations, contract execution (ranging from $1M-$5M+), including commercial structuring, benchmarking, and negotiation for healthcare operations (e.g., Claims, Enrollment, Customer Service, Care Management, Clinical Services, BPaaS, Operational IT tools) vendors. The Category Manager partners closely with business leadership to drive strategic value, enhance performance, support transformation initiatives, and ensure compliance with security, privacy, and regulatory requirements.
HMSA

About HMSA

The Hawaii Medical Service Association (HMSA), an independent licensee of the Blue Cross and Blue Shield Association, is a reliable name in Hawaii health care. Established in 1938, we are the largest and most experienced provider of health care coverage in the state. Over half of Hawaii’s population have chosen HMSA for their health care coverage.

We are dedicated to providing quality, affordable health plans; employee benefit services; and worksite wellness programs. HMSA also offers a variety of programs, services and support to help improve the health and well-being of our members and community.

Industry
Finance & Insurance
Company Size
1,001-5,000 employees
Headquarters
Honolulu, Hawaii
Year Founded
1938
Website
hmsa.com
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