Senior Manager:Provider Network Relations & Contracting

AfroCentric Group; Johannesburg; On-site; ZAR 1,200,000 - 1,800,000; Full time

Job summary

AfroCentric Group is seeking a senior health care professional to drive provider network development, contracting and risk management initiatives. You will lead engagement with hospitals, providers and clients to ensure high-quality, cost-effective care and strong stakeholder partnerships.

The role emphasizes strategic projects, tender leadership and building high-performing teams focused on continuous improvement and operational excellence.

Qualifications

• 10 years health care experience relating to provider engagement, network management and stakeholder engagement with sound analytical and problem-solving knowledge.
• 5 years experience in hospital case management and hospital & provider claims assessing and auditing; leadership experience.

Responsibilities

• Develop and execute provider network and contracting strategies supporting quality care and client value.
• Lead provider engagement, network management and relationship-building across hospitals and professionals.
• Negotiate, implement and manage provider contracts aligning to clinical and financial objectives.
• Drive risk management initiatives through collaboration with providers and stakeholders.
• Monitor network performance, utilization trends and provider outcomes with improvement plans.
• Identify opportunities to improve network effectiveness and member access to quality care.
• Lead strategic projects, tenders and initiatives enhancing provider value propositions.
• Manage stakeholder relationships with clients, providers, hospitals, industry partners and executive leadership.
• Drive customer-centric service delivery by understanding and addressing provider and client needs.
• Lead and develop high-performing teams with focus on innovation and operational excellence.

Skills

Provider engagement

Relationship management

Leadership

Analytical thinking

Problem-solving

Stakeholder engagement

Job description

Position Purpose

To participate in the development, implementation and ongoing management of health risk management initiatives focusing on the central role of healthcare professionals. In addition, there is a requirement to engage with client schemes to position and ultimately implement these initiatives

Experience

10 years’ health care experience relating to provider engagement & relationship management, network management and stakeholder engagement with sound analytical and problem-solving knowledge and 5 years’ experience in hospital case management and hospital & provider claims assessing and auditing. Leadership experience.

Key Outputs

• Develop and execute provider network and contracting strategies that support quality healthcare delivery, sustainable costs and client value.
• Lead provider engagement, network management and relationship-building initiatives across hospitals, healthcare professionals and strategic partners.
• Negotiate, implement and manage provider contracts, ensuring alignment to business, clinical and financial objectives.
• Drive healthcare risk management initiatives through collaboration with providers and stakeholder groups.
• Monitor network performance, utilisation trends and provider outcomes, implementing improvement plans where required.
• Identify opportunities to improve network effectiveness, operational efficiency and member access to quality care.
• Lead strategic projects, tender submissions and business initiatives aimed at enhancing provider value propositions.
• Manage stakeholder relationships with clients, providers, hospitals, industry partners and executive leadership.
• Drive customer-centric service delivery by ensuring provider and client needs are understood and addressed proactively.
• Lead and develop high-performing teams while promoting innovation, continuous improvement and operational excellence.

The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of line managers.

Our Commitment to Transformation

AfroCentric is committed to transformation and embracing diversity. Our Employment Equity plan and targets will be considered as part of the recruitment process. This commitment is what drives us to achieve a diverse workplace with employment equity as a key goal to create an inclusive workforce, representative of the demographics of our society as well as people with disabilities.

Should you not hear from us within a month of applying, consider your application unsuccessful.