Provider Networks Manager

Unity Health; Gauteng; On-site; ZAR 800 000 - 1 000 000; Full time

Job summary

A prominent healthcare provider in South Africa is seeking a Provider Networks Manager to oversee the Networks Team. The role involves developing and maintaining the provider network, negotiating contracts, and ensuring high-quality care for members. Ideal candidates will have strong leadership skills, excellent problem-solving abilities, and significant experience in the healthcare sector.

Qualifications

• Minimum of 6 years' experience in the South African healthcare market.
• 3 years in a similar role involving healthcare provider network development.
• Strong leadership skills with team management experience.

Responsibilities

• Manage the Networks Team to ensure company and provider support.
• Develop and maintain the national Unity Health provider network.
• Establish and monitor provider distribution across demographics.

Skills

Commercial Degree / Diploma

FAIS Compliant (RE 5 and class of business)

Valid driver's licence

Tools

Microsoft Office

Job description

Unity Health is a well-established primary healthcare provider in the South African market.

Our mission is to offer primary healthcare insurance solutions to the vast majority of South Africans.

We are searching for a Provider Networks Manager who will manage the Networks Team and ensure that our company and its providers are supported.

The successful candidate will collaborate with the team to maintain operational service commitments, as well as the organisation's mission and values.

The successful candidate will report to our Operations Executive.

Qualifications

• Commercial Degree / Diploma
• FAIS Compliant (Qualification, RE 5 and class of business a must)
• Valid driver's licence

Responsibilities

• Minimum of 6 years' experience in the South African healthcare market, with at least 3 years in a similar role involving healthcare provider network development and management.
• Proven track record in the negotiation, contracting, and management of healthcare providers across multiple disciplines: GPs, dental practitioners, pharmacies, radiologists, pathologists, optometrists, emergency services, hospitals (private and public), and out-patient casualty units.
• Demonstrate experience managing provider network utilisation.
• Strong leadership experience, with the ability to manage, mentor, and develop a team of consultants.
• Ability to work independently and exercise sound judgment and discretion in a complex and dynamic environment.
• Excellent verbal and written communication skills, with the ability to communicate at all levels, including with medical professionals and executive stakeholders.
• Highly proficient in Microsoft Office and other relevant business systems; ability to interpret and act on data.
• Ability to work under pressure, prioritise effectively, and maintain professionalism at all times.
• Have a proactive approach, take ownership, strong problem‑solving ability, and a commitment to team collaboration.
• Develop, manage, and maintain the national Unity Health provider network, ensuring optimal access, cost‑efficiency, and quality of care for members.
• Establish and monitor appropriate provider distribution to meet network adequacy standards across geographic and demographic segments.
• Lead the development and execution of provider contracting strategies, including new provider acquisition, ongoing relationship management, and renewals.
• Conduct regular provider visits to strengthen relationships, monitor service quality, and drive ongoing provider education and engagement.
• Ensure consistent adherence to agreed service levels and quality metrics by providers.
• Develop and implement Standard Operating Procedures (SOPs) for the setup, management, and review of provider agreements and daily operations.
• Ensure accuracy and integrity of provider network data across all systems, enabling accurate administration and reporting.
• Design, negotiate, and manage provider fee structures in line with business strategies and market conditions.
• Monitor utilisation patterns, identify trends, and collaborate with internal teams to address inefficiencies and cost drivers.
• Lead and participate in interdepartmental projects to enhance systems, workflows, and overall network performance.
• Manage escalated provider or member issues where network involvement is required.
• Drive team performance through coaching, regular feedback and performance reviews (KPAs).
• Provide input into budget planning, cost management, and the strategic direction of the provider network's function.
• Ensure efficient use of travel budgets through careful route planning, managing accommodation and daily allowances, and maximising provider coverage per visit to ensure cost‑effective network engagement.
• Prepare reports and presentations for internal and external stakeholders, including executive-level reporting.
• Ensure the healthcare provider network includes a well‑balanced mix of providers across relevant areas.
• Any other duties as assigned by the company from time to time.