Network Partner Operations Specialist

The Network Partner Operations Specialist is responsible for owning the day-to-day operational relationship with global assistance partners and specialty services vendors that coordinate access to care for all BCBS Global Solutions clients/customers traveling or working abroad. This role serves as the primary internal point of contact for partner inquiries and escalations, coordinating cross-functional internal workflows (e.g., Operations, Finance, Clinical, Compliance, and Client Service) to drive timely resolution and improve recurring issues. The role supports the Manager of Network Partnerships and Strategic Development by ensuring contractual obligations are met, service quality is maintained, and operational performance is monitored-enabling leadership to focus on macro issues and strategic relationship development.

Responsibilities:

1. Partner operational Management & Issue Resolution

• Own intake, triage, and resolution management for day-to-day assistance partner inquiries (operational, eligibility/coverage workflow questions, billing/payment inquiries, service concerns), ensuring the right internal teams are engaged and updates are communicated back to the partner.
• Serve as the primary operational internal advocate for assigned global partners, acting as the central point of contact for operational and business inquiries and maintaining a structured case log (category, priority, owner, SLA, status, root cause, resolution).
• Coordinate and drive internal workflows through resolution, including escalation management, follow-ups, and documentation of outcomes; ensure consistent, timely responses aligned to service expectations.
• Participate in new partner onboarding, quarterly operational check-ins, and ongoing communication with assistance partners; capture action items and ensure completion.
• Support internal teams in understanding partner capabilities and processes; communicate internally on partner updates/changes that impact operations.
• Track and report on monthly payment reconciliation activities including payment aging and inquiry trends; drive resolution of escalated payment inquiries and recurring partner-related operational challenges.

2. Assistance Partner and Specialty Partner Data Management & Maintenance

• Maintain the assistance partner database and documentation repository (contracts, Business Associate documentation, Third Party Risk assessments, service profiles, contact lists, escalation paths), ensuring accuracy, version control, and audit readiness.
• Maintain client listings and operational tracking for security vendor relationships, including PEND contracts and processes for pre-approvals and coverage validation for travel to designated countries.
• Support contract negotiation, renewal, and mid-term updates by coordinating inputs, tracking timelines, and ensuring operational requirements are captured and communicated.
• Support vendor governance processes and ensure compliance with internal policies and partner obligations; identify documentation gaps and drive closure.

3. Reporting & Performance Analytics

• Develop, track, and report operational KPIs (e.g., inquiry volumes by category, SLA attainment, aging/backlog, first-response time, payment inquiry trends, repeat issues) in partnership with Global Healthcare Delivery leadership.
• Analyze inquiry and escalation themes to identify root causes; recommend process improvements, training needs, and partner-facing clarifications to reduce repeat volume and improve partner experience.

4. Internal Support & Training

• Train internal teams on partner programs and workflows.
• Maintain partner reference guides and documentation.
• Assist with special projects, RFP support, and other assigned initiatives.

Requirements:

• Bachelor's degree required (or equivalent combination of education and experience).
• 3-5+ years of experience in healthcare, insurance, global networks/assistance, vendor operations, or related operational support roles.
• Experience working with assistance partners (or comparable external operational partners/vendors) preferred.
• Strong written and verbal communication skills; able to translate partner issues into clear internal actions, manage multiple priorities, and provide structured status updates
• Proficiency with Microsoft Office (Excel, PowerPoint, Teams, CoPilot, SharePoint); experience with case/workflow tools and reporting platforms (e.g., Salesforce, SharePoint, ServiceNow/Jira, Power BI) preferred.
• High-speed Internet (75 Mbps minimum) for remote work.
• International health insurance experience is preferred

Client-provided location(s): Gunnison, CO

Job ID: geoblue-609127

Employment Type: OTHER

Posted: 2026-07-25T20:08:17