Company Overview
International SOS Government Services provides specialized, integrated, and innovative services ensuring quality health care outcomes, reducing medical risk for governments, military, and international organizations. Our global solutions support a broad range of healthcare needs with a team of 13,000 experts working across 90 countries.
Overall Purpose of the Job
The Network Liaison Manager is responsible for recruiting and onboarding a profitable and adequate network of providers across all major metropolitan cities in Canada to deliver services in alignment with contractual requirements and KPI. This is achieved through a network that has cost optimal provider pricing, compliance with the required provider qualification as per contracting requirements, and delivery of service requirements of the VBA MDE Network.
This is a front-line role, customer-facing, and customer advocacy role responsible for engaging with providers pre- and post- agreement to participate in the network. The role will discuss and understand how the provider operates, administrative requirements to establish their provider file and the provider payment preferences. This includes delivery of any provider training and supporting the ongoing day-to-day service delivery for providers within the defined portfolio
Key Responsibilities
- Identification, negotiating price, contracting, and onboarding of providers to ensure they meet the requirements set for the VBA MDE Program.
- Ensure that the provider data and credentials are kept up to date in SPIN system, compliant with contractual requirements and Group Network Services Standards and Procedures.
- Manage new provider partnerships including price negotiation, collection of key provider file information for the provider file set up and ensuring a comprehensive understanding of the provider preferences for participation under the program (Relationship Management “RM”).
- Serve as a primary point of contact for provider network issues and resolution (RM).
- Manage the Provider schedule of availability to identify gaps and meet booking requirements.
- Monitor the calendar of appointments and submission of information within the predefined calendar days.
- Contact providers to proactively identify discrepancies in their availability schedule.
- Ensure medical and personal data confidentiality is maintained.
- Interact with Regional and Group Government Services leadership to discuss network demands, validate network issues and resolve network gaps.
- Monitor assigned area against established network adequacy and access standards; identify network gaps and track shortfalls through capacity tools; translate gaps into recruitment targets.
- Develop a commercial network development plan in partnership with the VBA Program Network Manager and regional Operations Manager.
- Establish and maintain positive working relationships with all customers; responds to emails, phone calls, customer service inquires by fully researching the inquiry and responding promptly.
- Communicate and assist with resolving escalated care issues related to provider network issues; utilize resources and tools to resolve escalated issues; document access to care issues.
- Conduct operational and medical training as needed with providers related to compliance requirements, programs, and processes; recommend future provider educational needs based on observations and discussions with providers and questions raised during live and web-based training (RM).
- Provide feedback to management about claims processing, referral/authorization, or other unfavourable trends from provider interactions (RM).
- Deliver periodic status reports.
- Manage day-to-day relationships and region-specific needs of assigned provider base.
- Provide feedback and input to provider support materials (RM).
- Engage in regular provider visits across the region (RM).
Customer & Provider Relationship Management
- Be accessible and responsive to clients, providers and colleagues’ questions, concerns and requests for information.
- Deal positively with internal/external complaints, including those from providers and members; these are to be resolved wherever possible in a timely manner, or referring them to the appropriate department/Network Services/Management.
- Maintain a courteous and professional manner at all times when dealing with service providers, customers, and colleagues.
Liaison
- Establish responsive liaison arrangements both within International SOS and externally.
- Positively promote International SOS to other organizations and providers.
- Be accountable to the Managers regarding workload and issues.
Other Duties
- To attend supervision, training and meetings as and when required (there may be a necessity for these to sometimes be outside normal working hours).
- To work within and promote all International SOS policies and procedures.
- To carry our any other reasonable duties as requested by the Managers.
Required Skills and Knowledge
- Knowledge of local provider networks and the business relationship between providers and beneficiaries.
- Ability to negotiate pricing and contracting with a provider network
- Proficient with data entry and provider database systems; proficient with Microsoft Office products including Outlook and Excel.
- Ability to solve problems through systematic analysis of processes and application of judgment.
- Ability to organize people/tasks, adjust to priorities, learn systems, within time constraints and with available resources, detail orientation.
- Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.
- Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.
- Critical thinking with the ability to focus on things which matter most to achieving outcomes.
- Commitment to deliver outcomes without direction and to find necessary resources.
- Resilience in adapting to a variety of situations while maintaining a sense of purpose and demonstrating a mature problem-solving approach.
- Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.
- Ability to influence or persuade others.
- Adapt to different styles; Listen critically; Collaborate.
Required Work Experience
- Previous experience in recruiting and onboarding providers preferably in a commercial provider management role (highly preferred)
- Recruitment
- Negotiation
Required Qualifications
- Bachelor’s Degree
- Work experience in a service industry environment
Required Languages
- Fluent in English
- French desirable
Job Conditions
- Travel required within Canada.
- To work at other Intl.SOS locations as and when required (job condition).
- To work flexible hours as appropriate to the needs of the post.
Pay: $75,000.00-$82,000.00 per year
Work Location: Remote
