**Overall Purpose of the Role**:
**Focus: Provider Network Management**
The QTC VA Program Network Services Liaison Officer is responsible for establishing the VA network in the designated countries. This role will contract and negotiate the pricing and contract terms with our providers.
Maintaining market pricing will be key to the success of this role, so on-going price negotiations, selection of new providers and exploring new commercial options for delivery of the service will be required.
It will also be responsible for enrolling, registering and managing the relationships with strategically selected providers to the QTC VA Network.
This position serves as the primary contact to an assigned QTC VA Network to ensure there is sufficient provider supply and availability to meet the demands of the program.
This position will develop and maintain provider relationships in the assigned territory to ensure network demands are met. This role will also be responsible for educating providers on processes, contract and performance requirements. It will operate as an intermediary between International SOS and Providers on education needs, while also assisting with facilitating resolution of escalated provider issues.
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**:
**Specific Responsibilities**
- Identification, negotiating price, contracting, and onboarding of providers to ensure they meet the requirements set for the QTC US Veteran Programme
- Ensure that the provider data and credentials are kept up to date in SPIN system, compliant with 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 programme (Relationship Management "RM")
- Serve as a primary point of contact for provider network issues and resolution (RM)
- Interact with Network Services, WorkSafe and 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 VA Program Network Manager
- 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 Qualifications**:
**Required Skills and Knowledge**
- Knowledge of local provider networks and the business relationship between providers and beneficiari