Provider Network Manager

Job Title: Provider Relations Manager Company Overview Our organisation is a well-established healthcare provider within the South African market. Our mission is to offer accessible healthcare solutions across the country, ensuring our services are supported by a strong network of providers. We are searching for a Provider Relations Manager who will manage a team and ensure that our company and its providers are fully supported. The successful candidate will collaborate with the team to maintain operational service commitments, as well as the organisation’s mission and values. Position Overview The Provider Relations Manager reports directly to the Operations Executive. Qualifications The role requires a Commercial Degree or Diploma. Candidates must be fully FAIS Compliant, possessing the relevant qualification, RE 5, and class of business certifications. A valid driver’s license is also mandatory. Skills and Experience Candidates must possess a minimum of 6 years’ experience in the South African healthcare market, with at least 3 years spent in a similar role involving healthcare provider network development and management. We require a proven track record in the negotiation, contracting, and management of healthcare providers across multiple disciplines, including GPs, dental practitioners, pharmacies, radiologists, pathologists, optometrists, emergency services, hospitals, and out-patient casualty units. Experience in managing provider network utilisation is essential. Strong leadership skills are necessary to successfully manage, mentor, and develop a team of consultants. The ideal candidate must be able to work independently, exercise sound judgment, and maintain a high level of professionalism under pressure in a complex environment. Exceptional verbal and written communication skills are required to interact effectively at all levels, including with medical professionals and executive stakeholders. Proficiency in Microsoft Office and other business systems is required, alongside the ability to interpret and act on data. Candidates should demonstrate a proactive approach, take ownership of tasks, possess strong problem-solving abilities, and maintain a commitment to team collaboration. Scope of Responsibility Network Development and Strategy The manager develops, manages, and maintains the national provider network to ensure optimal access, cost-efficiency, and quality of care for members. This includes establishing and monitoring appropriate provider distribution to meet network adequacy standards across geographic and demographic segments. The successful candidate leads the development and execution of provider contracting strategies, focusing on new provider acquisition, ongoing relationship management, and renewals. Additionally, they design, negotiate, and manage provider fee structures in line with business strategies and market conditions. Relationship Management and Operations Responsibility includes conducting regular provider visits to strengthen relationships, monitor service quality, and drive ongoing provider education and engagement. The manager ensures consistent adherence to agreed service levels and quality metrics by all network providers. To streamline workflows, they develop and implement Standard Operating Procedures for the setup, management, and review of provider agreements and daily operations. They are also responsible for the accuracy and integrity of provider network data across all systems to enable precise administration and reporting. When escalated provider or member issues arise that require network involvement, the manager handles the resolution process. Data and Financial Management The manager monitors utilisation patterns, identifies trends, and collaborates with internal teams to address inefficiencies and cost drivers. They provide critical input into budget planning, cost management, and the overall strategic direction of the provider network's function. This financial oversight includes ensuring the efficient use of travel budgets through careful route planning, managing accommodation and daily allowances, and maximising provider coverage per visit to guarantee cost-effective network engagement. Leadership and Reporting The role drives team performance through consistent coaching, regular feedback, and formal performance reviews based on KPAs. The manager prepares comprehensive reports and presentations for internal and external stakeholders, including executive-level reporting. They lead and participate in interdepartmental projects aimed at enhancing systems, workflows, and overall network performance. Finally, they ensure the healthcare provider network maintains a well-balanced mix of providers across all relevant areas, and they perform any other duties as assigned by the company from time to time.