Provider Network Manager - Latin America & Canada

Provider Network Manager - Latin America & Canada Essential

Job Duties and Responsibilities:

At International SOS, we are in the business of protecting and saving lives. For 40 years, we have delivered customised security risk management, health, and wellbeing solutions to organisations worldwide. With a presence in 90 countries and a team of nearly 13,000 experts, we provide 24/7 support to help organisations fulfil their Duty of Care responsibilities.

Now, we’re looking for talented individuals to join our team and make a difference.

Overall Purpose of the Job

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

Essential Job Duties and Responsibilties

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
• 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

Other responsibilities

• 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

Required Skills and Knowledge

• 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)
• Delivering…