Provider Network Manager - Latin America & Canada

International SOS•San Antonio, TX

16h•$60,000 - $62,000•Remote

About The Position

The Provider Network Manager is responsible for managing the relationships of strategically selected host nation providers to the TOP Network for the Remote sites in the Latin America region. This involves providing support for participating providers to fulfil on the requirements of the program, ensuring they are satisfied with the agreed processes and are paid in a timely and efficient manner. This is a front line, provider customer facing and customer advocate role responsible for engaging with providers and TOP Remote POCs understand how they operate, what their pain points are, how to achieve the best outcome while staying within contractual scope and requirement. This includes engagement at the provider, TOP Remote POCs leadership level to improve the TRICARE program goals or rectify concerns. This role requires a customer centric focus, a good process and operational understanding and the ability to learn and teach stakeholders on TOP systems and processes along with the ability to work together with senior provider and client stakeholders and influence provider and stakeholder decisions. The role is also responsible for liaising and participating in cross functional teams and projects as required to support our provider base, including but not limited to working with the Program Management, Network Quality Teams, Network claims teams, technical teams, operations teams and International SOS local Global Assistance Network managers to ensure a service delivery and overall beneficiary. This position is Remote

Requirements

Ability to understand requirements of the Corp procedures and guidelines, TRICARE Overseas Program as well as the TRICARE Network KPI’s
Strong administrative and organizational skills
Very good communication and interpersonal skills (verbal/written)
Ability to develop, build, and maintain partnerships across a diverse range of internal and external contacts within a multicultural environment
Ability to prioritize, and manage time effectively
Ability to take initiative, challenge and question existing processes and procedures
IT literate (Word, Excel, PowerPoint)
Proven service delivery experience in a professional services B2B environment or senior account management experience or program management experience
Bachelor’s degree, equivalent or qualification by experience
Highly proficient in English and Spanish (written and verbal)

Nice To Haves

Previous exposure to healthcare and healthcare provider management a plus
Familiarity with healthcare standards in AOR.

Responsibilities

Service Provider Credentials & Data Quality Review
Direct contact (phone, e-mail, fax) with providers to obtain credentials, information, and update in SPIN
Maintain credentialing objectives as per TRICARE network KPIs (LI, MI, ICP) and in addition maintain accreditation status for TOP Network hospitals
Ensure data integrity and accuracy as outlined in the Corp and TRICARE guidelines
Validate documents uploaded in SPIN (correct and fully completed)
Validate and translate key information of any documents, where this has been received in the host nation language
Specialized Network Management: ABA, Telehealth, Mental Health Services
Ensure credentialing processes are followed
Positively promote International SOS and the TRICARE Overseas Program to service providers, maintaining good relations
Collaborate with Network Services Support Team Leader in outcomes of quality reviews and audits of SPIN Provider Profiles, participate in training and QIP when required
Manage new provider partnerships and ensuring a comprehensive understanding of the provider preferences and their participation under the TOP Program
Manage DoS Health Unit partnerships to ensure a comprehensive understanding of the TOP program and associated support service
Establish relationship management plan and execute schedules and milestones on time (note: that this is not a sales job where new leads are developed through cold calling, in all but exceptional instances leads are in place and require development and management)
Educate on TOP Policy and any self-service mechanisms available for stakeholders
Deliver periodic status reports to internal and external clients
Provide ongoing provider support through issue resolution and customer service
Manage day-to-day relationships and region specific needs of assigned are of responsibility (AOR)
Compilation of data for account management of AOR
Take an active part in the ongoing evolution of International SOS TOP Provider Network services
Engage with providers and key client points of contact to understand, analyze, document and influence the direction of the TOP Provider Network Function and self service enhancements
Identify key problem areas of client and / or provider concerns and coordinate resolution
Provide feedback and input to provider support materials