Manager - Global Networks

• Monitors Provider Relations and Provider Finance supervisors and team leads for quality. Works with same to identify areas for training or additional education.

• Refines and expands the capacity model for both teams in conjunction with the director of GHM Reporting, Quality, and Operational Analytics

• Manages team performance to meet departmental goals.

• Provides input and advises on staffing models and required departmental competencies.

• Leads interview process for new staff candidates.

• Works with the Learning & Development team to schedule and coordinate new hire and refresher training.

• Oversees and monitors training of new staff.

• Conducts 1x1 meetings with direct reports to provide feedback and discuss cases.

• Identifies process improvements and evaluates workflow, systems, and other tools for efficiency and department use.

• Builds relationships with contracted doctors and hospitals.

• Identifies and recruits individual providers and facilities for network growth.

• Manages contracting process with international doctors and hospitals.

• Assists with complex negotiations and advises on negotiation strategies for contracts and pricing.

• Conducts quality assurance of new provider discounts.

• Evaluates provider complaints and works with Director - Global Networks to resolve.

• Participates in monthly Provider Finance/Claims meeting to discuss issues and opportunities to improve service and efficiency.

• Collaborates with the Transformation and Digital teams to ensure successful development and completion of department applications, new technologies, and other enhancements.

• Works effectively with colleagues in Client Management, Claims, Finance, and the Global Service Center to investigate and resolve provider issues.

• Works closely with the Fraud, Waste, and Abuse team to ensure agreed pricing is usual, reasonable, and customary.

• Supports Sales and Client Management efforts with client's specific research and reports.

• Manages annual network update processes and supervises vendors to ensure SLAs are met.

• Represents Global Networks in cross-departmental projects.

• Other duties and projects as assigned.

Requirements:

• Bachelor's degree required.

• 3-5 years international provider networks or international insurance experience

• Prior supervisory experience in related field(s)

• Substantial international travel or expatriate experience

• Outgoing personality

• Excellent verbal and written communication skills to effectively work with employees, customers, vendors, and other departments.

• Extremely detail-oriented with strong organizational and people-management skills

• Ability to work effectively with international healthcare providers

• Ability to make decisions and support them with documentation

• Excellent knowledge of world geography

• Fluency in one or more foreign languages

• Familiarity with Microsoft 365 applications, particularly Word, Excel, and SharePoint

• Familiarity with Salesforce (Health Cloud)

• Employee is required to have at minimum an internet speed of 75 Mbps (standard high-speed internet access).

Working Conditions:

• Flexibility to work in an office and/or at-home, remote office environment.

• Schedule flexibility is occasionally necessary in this position. Individual may be required to attend key business/departmental meetings and/or perform certain business critical job functions outside of normal working hours.

• Physical Demands: Must be able to communicate internally and externally through receiving and responding to auditory and visual methods.

Competitive base pay starting at $90,868 annually. Compensation is based on prior/relevant experience and skill level in a similar role.

This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned.

Client-provided location(s): King of Prussia, PA

Job ID: geoblue-513674

Employment Type: FULL_TIME

Posted: 2024-07-26T12:38:26