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Responsibilities:
Drafting contracts with network providers and obtaining approvals from all key stakeholders, Storing documents in proper system
Onboarding all new providers (system setups, SPP , PBM)
Provider price/tariff revisions
Provider updates on the system regarding bank, license, clinician, networks details, etc.
Managing the e-mails in the network mailbox/ticketing tool
Updating the network list on monthly basis and share the same with internal stakeholders & keeping provider locator up to date in Client Website
Mass communication to all providers when required
Manage network complaints to improve customer experience when necessary, making outbound calls, receiving calls from providers
Preparing documents for SOP, process maps, manuals
Identifying system gaps, performance issues and requesting system enhancement/ bug fixing to improve efficiency
Performing system UATs
Joining meetings, representing the department
Preparing monthly Steerco presentations, calculating TAT, SLA related to department
Supporting TPA processes related to provider coding
Job ID: 135821221