Provider Network Manager - Latin America & Canada

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 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

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)

Required Competencies

• Delivering Results & Meeting Customer Expectations: Focuses on customer needs and satisfaction; Sets high standards for quality and quantity; Monitors and maintains quality and productivity; Works in a systematic, methodical and orderly way; consistently achieves project goals. 
• Coping with Pressure & Setbacks: Works productively in a pressurized environment; Keeps emotions under control during difficult situations; Balances the demands of a work life and a personal life; Maintains a positive outlook at work; Handles criticism well and learns from it. 
• Persuading & Influencing: Makes a strong personal impression on others; Gains clear agreement and commitment from others by persuading, convincing and negotiating; Promotes ideas on behalf of self or others; Makes effective use of political processes to influence and persuade others. 
• Analyzing: Analyses numerical data, verbal data and all other sources of information; Breaks information into component parts, patterns and relationships; Probes for further information or greater understanding of a problem; Makes rational judgements from the available information and analysis; Produces workable solutions to a range of problems; Demonstrates an understanding of how one issue may be a part of a much larger system.
• Presenting & Communicating Information: Speaks clearly and fluently; Expresses opinions, information and key points of an argument clearly; Makes presentations and undertakes public speaking with skill and confidence; Responds quickly to the needs of an audience and to their reactions and feedback; Projects credibility.

Required Work Experience 

• Proven service delivery experience in a professional services B2B environment or senior account management experience or program management experience
• Previous exposure to healthcare and healthcare provider management a plus 
• Familiarity with healthcare standards in AOR.

Required Qualifications

• Bachelor’s degree, equivalent or qualification by experience

Required Languages 

• Highly proficient in English and Spanish (written and verbal) 

Travel / Rotation Requirements   

• As required in assisting Network Site Assessment Teams 
• TRICARE working hours