Network Manager-Healthcare

Requirements:

A three-year tertiary clinical/business national diploma/degree with seven years relevant experience in network provider management, of which three years must be in healthcare; OR

Grade 12 with 10+ years relevant experience in network provider management, of which five years must be in healthcare.

Must have knowledge and professional experience of the following:

Provider network management; -

Primary, secondary and tertiary care services processes and practices;

The Medical Schemes Act and Regulations; - Healthcare provider industry;

Healthcare funding industry; Understand and know the company medical options and benefits and specifically how they relate to primary care.

Must have the following skills: - Excellent relationship building skills; - Persuasiveness and negotiation skills; - Liaison skills; - Developing alliances; - Leadership; - Innovation; - Business insight; - Customer focus; and - Financial insight.

Computer literate in MS Office.

Functions:

Build relationships with general practitioners – those servicing network members as well as non-network members.

Liaise with the Health Innovation team with the aim of structuring the framework for an optimal general practitioner provider grouping.

Prioritise the general practitioners to be targeted, taking the General Practitioner Alliance goals into consideration.

Assist in drafting the agreement of collaboration that the organisation offers for participation to the General Practitioner Alliance members.

Build relationships with the organisation’s General Practitioner Alliance offices, including providers, practice managers and frontdesk staff.

Provide continuous direct axis support to practices.

Identify pain points and service issues during engagement with the organisation’s General Practitioner Alliance practices and ensure they are addressed and monitored. Develop close working relationships with the support staff of network administration and ensure that administrative matters related to the practices and services rendered are attended to.

Liaise with contact staff in all departments where queries from practices need to be resolved, e.g. claims, chronic medicine, etc.

Assist in drafting a practice profile report, visit log, practice query log and resolution timelines.

Utilise feedback questionnaires to gauge practice feedback on engagement matters. Ensure General Practitioner Alliance members understand the goals and metrics that are structured to measure their collaboration and the remuneration that accompanies these metrics.

Continuously interact with general practitioners to ensure they understand the vision and goals, and pay specific attention to general practitioners where poor metrics persist.

Compile a quarterly report on all the organisation’s General Practitioner Alliance activities.

Ensure constant operational efficiency through innovation within areas of control. Ensure adherence to all legislative and regulatory prescripts.

Continuously evaluate plans, actions and resources to ensure that objectives are achieved.

Manage the budget in order to utilise resources effectively and achieve objectives.