Operations Manager
1 week ago
Tricare Overseas Program Operations Manager – Medical Claims
Location:
Manila, Philippines
Company:
International SOS (Tricare Overseas Program)
About the Role
International SOS, in partnership with Tricare—the U.S. Department of Defense's healthcare program—is seeking an experienced Operations Manager to lead our Tricare Overseas Program (TOP) in the Philippines. This role supports over 12,000 Tricare-eligible beneficiaries by managing a dedicated network of healthcare providers across the archipelago.
Key Responsibilities
- Oversee and manage a Manila-based team covering two service delivery areas:
- Certification Team:
Review and certify institutional and non-institutional providers as authorized Tricare providers. - Global 24 Network Service Team:
Administer and support claims processing and reconciliation across Metro Manila, North Philippines, South Philippines, and Iloilo. - Provide hands-on supervision to ensure process adherence, accuracy, risk management, compliance, and forward planning.
- Develop and strengthen relationships with healthcare providers.
- Act as the senior escalation point and owner for Philippines Provider Network issues.
- Engage with the International SOS Global Assistance Network Manager to develop strategic partnerships.
- Collaborate with Tricare provider support services staff in Singapore for effective claims management.
- Lead planning and approval of provider network visits to meet contractual requirements.
- Build, educate, and deepen provider relations at a senior level, ensuring claims are properly submitted and paid.
- Respond to claims-related queries, assist with submissions and reconciliation, and escalate as needed.
- Attend provider events, meetings, and internal/external education offerings.
- Lead process improvement activities within the broader regional Tricare operations.
Requirements
- Minimum 10–12 years of successful operational management experience in a customer service environment.
- Experience in healthcare claims, financial services, insurance, or client service delivery preferred.
- Proven track record in provider management, including network agreement negotiation.
- Demonstrated success in operations development and delivery.
- Seasoned people management skills with a history of coaching and developing operational teams.
- Strong customer service orientation and attention to detail.
- Highly effective communicator at all organizational levels and with senior external providers.
Why Join Us?
- Make a meaningful impact on the lives of Tricare beneficiaries across the Philippines.
- Work with a global leader in healthcare assistance and network management.
- Lead a dynamic team and drive operational excellence in a fast-paced environment.
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