Senior Manager:Provider Network Relations & Contracting

AfroCentric Group; Johannesburg; On-site; ZAR 900,000 - 1,100,000; Full time

Job summary

AfroCentric Group is seeking a senior professional to participate in health risk management initiatives, engaging with providers, hospitals and clients to enhance value and outcomes.

The role focuses on developing networks, managing contracts and driving performance improvements across healthcare partnerships in Johannesburg. Leadership and analytical skills are essential for delivering client-focused solutions.

Qualifications

• 10 years' health care experience in provider engagement, relationship and network management.
• 5 years' hospital case management and hospital/provider claims auditing.
• Demonstrated leadership experience.

Responsibilities

• Develop and execute provider network and contracting strategies.
• Lead provider engagement, network management and relationship-building with hospitals and professionals.
• Negotiate, implement and manage provider contracts.
• Drive healthcare risk management initiatives with providers and stakeholders.
• Monitor network performance, utilization trends and outcomes; implement improvements.
• Identify opportunities to improve network effectiveness and member access.
• Lead strategic projects and tender submissions.
• Manage stakeholder relationships with clients, providers and leadership.
• Drive customer-centric service delivery by understanding provider and client needs.
• Lead and develop high-performing teams with focus on innovation and excellence.

Skills

Provider engagement

Relationship management

Network management

Stakeholder engagement

Leadership

Education

Clinical qualification

Business qualification advantageous

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.

Qualifications

Clinical qualification, Business qualification advantageous

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.

Turnaround Time

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.