PROVIDER NETWORK MANAGER manages the operations of a healthcare provider network. Responsible for establishing and maintaining processes and systems to provide routine services to members including contract management and credentialing. Being a PROVIDER NETWORK MANAGER recruits, hires, trains, and measures performance of staff to provide effective and operations within budget. May be involved with the design and operations of database systems used to manage provider data and produce reports and analysis. Additionally, PROVIDER NETWORK MANAGER requires a bachelor's degree. Typically reports to top management. The PROVIDER NETWORK MANAGER typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a PROVIDER NETWORK MANAGER typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
At International SOS we work to protect global workforces from health and security threats. We make a meaningful impact every day by safeguarding people and saving lives worldwide, 24/7.
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The Head of Provider Network and Claims, TRICARE Overseas Program (TOP) is responsible for the overall global operational performance and execution of the TOP provider network administration, global claims, and TOP enrollment. A subject matter expert and lead for Global Claims accountable for executing strategies to meet contractual KPIs and enabling beneficiary and provider satisfaction. Engages global teams to provide optimum beneficiary experiences, driving consistency, cost-effective solutions while leveraging data-led decisions and infusing new methodologies and/or technology. Drives end to end value for sustained scalable performance, develops talent management and retention strategies to ensure DHATOP PMO trust and satisfaction. Member of TOP Operations Leadership Committee focused on driving results, risk mitigation and overall performance. A key contributor to the overall TOP strategy.
This job description outlines the types of responsibilities the incumbent is required to perform.
The incumbent may be required to perform job related tasks other than those specifically presented in this job description. This job description is subject to regular review.
International SOS is an equal opportunity employer and does not discriminate against employees or job applicants on the basis of race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state and local laws.
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