Job Title: Specialist Network ManagerLocation: Tshwane Metro, Pretoria, BrooklynJob Type: Permanent, full-time hoursPrimary Industry: Health, Medical and relatedSecondary Industry: InsuranceQualifications: A relevant clinical or business related ND or Bachelor degreeSkills:Identify, evaluate and recruit healthcare providers with special emphasis on specialistsConduct market analysis to identify potential gaps in the networkNegotiate provider contracts with associated remuneration tiers and service level agreementsCollaborate with legal and compliance teams to ensure contracts align with regulatory requirementsServe as a primary point of contact for providers facilitating effective communication and collaborationParticipate in the profiling process and meetings and assist with the claims monitoring processEvaluate the performance of healthcare providers to ensure adherence to quality and standardsStay informed with relevant healthcare regulations and accreditation standardsEnsure adherence to all Medihelp policies guidelines and directivesUtilise data analytical tools to assess network performance, identify trends, and make data-driven decisionsPrepare regular reports on key performance indicators and present findings to leadership teamCollaborate with Marketing and Member Administration teams to develop educational materials for membersManage budget and ensure no deviationsEnsure constant operational efficiency through incremental innovation within the scope of workJob Duties: The Specialist Network Manager is responsible for identifying, evaluating, and recruiting healthcare providers with a special emphasis on specialists. They conduct market analysis to identify potential gaps in the network, negotiate provider contracts, and collaborate with legal and compliance teams to ensure regulatory compliance. The Specialist Network Manager serves as a primary point of contact for providers, evaluates provider performance, stays informed on healthcare regulations, and ensures adherence to company policies. They utilise data analytical tools to assess network performance, prepare reports, and collaborate with other teams to develop educational materials for members. Additionally, the Specialist Network Manager manages the budget, ensures operational efficiency, and drives incremental innovation within their scope of work.Experience: At least 7 years of experience in healthcare provider network management, within the context of medical schemes or health insuranceKnowledge And Skills:Strong understanding of healthcare provider networksExcellent negotiation and communication skillsAbility to analyse data and make data-driven decisionsFamiliarity with healthcare regulations and accreditation standardsProject management skillsWorking Conditions: The Specialist Network Manager works in an office setting, collaborating with various teams within the company. Occasional travel may be required to meet with healthcare providers or attend conferences.Closing date: 26 July 2024
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