Specialist Network Provider Manager

Recruiter:

Fusion Personnel

Job Ref:

JHB005442/Maris

Date posted:

Wednesday, May 21, 2025

Location:

Johannesburg, South Africa

Salary:

900000 Annually

SUMMARY:
Well-established company based in Johannesburg North seeks a Specialist Network Provider Manager to join their team!

POSITION INFO:
Requirements:

Diploma or Degree (NQF Level 5 or higher)
1–2 years of relevant experience, preferably in healthcare or insurance
Strong interpersonal, negotiation, and communication skills
Knowledge of healthcare regulations, claims processing, and contracting
Analytical, organized, detail-oriented, and able to manage multiple tasks
Proficient in MS Office and basic computer applications

Responsibilities:

Provider Network Management:
Build, negotiate, and maintain a network of medical specialists. Handle contracts, rate negotiations, and provider communications.
Strategy & Analysis:
Identify gaps in provider networks and implement strategies to enhance efficiency and coverage. Monitor return on investment of network initiatives.
Claims & Risk Management:
Oversee claims processes to ensure compliance with agreed terms. Resolve provider disputes and discrepancies.
Performance Monitoring:
Track provider performance and key metrics. Report outcomes and recommend improvements.
Compliance & Quality Assurance:
Ensure providers follow relevant regulations and quality standards. Conduct audits and stay updated on industry regulations.
Customer Service & Support:
Act as a main contact point for providers, addressing queries and concerns professionally.
Training & Development:
Educate network providers on procedures, standards, and updates.

Similar jobs you might be interested in:

Specialist Network Provider Manager
Location: Johannesburg
Salary: 900000 Annually
Well-established company based in Johannesburg North seeks a specialist Network Provider manager to join their team!
15 days ago

Multi-Manager Unitization Implementation Specialist
Location: Centurion
Salary:
Our client is a trusted name in the asset management industry, servicing a diverse client base with a strong emphasis on operational excellence and innovation. They are looking for a highly skilled Multi-manager Unitization Implementation specialist to join their investment operations team.
20 days ago

Events Specialist - Midrand
Location: Midrand
Salary: R500 000 Annually
Role OverviewThe Events specialist is responsible for the planning, coordination, and execution of all events within the Waterfall precinct and the broader property portfolio. This includes public-facing events, paid-for experiences, internal corporate functions, client activations, and sponsorship initiatives. The role requires a detail-driven project manager with excellent coordination skills, s...
Today

Sales Representative / Key Account Specialist (Signage/Graphics exp)
Location: Johannesburg
Salary:
1 day ago

Information Systems Audit (Cybersecurity) Senior Manager
Location: Pretoria
Salary: 1500000
Are you an Information Systems Audit (Cybersecurity)
2 days ago

JUNIOR IT TECHNICAL PROJECT MANAGER
Location: Johannesburg
Salary: R45-55K PER MONTH
JUNIOR IT TECHNICAL PROJECT manager
2 days ago

Kronos Manager
Location: Johannesburg
Salary:
2 days ago

Financial Manager
Location: Johannesburg
Salary: 1200000 Annually
Step Into the Engine Room of a Global Giant!
4 days ago

Senior Accountant
Location: Johannesburg
Salary: 500000
Are you a numbers-driven professional looking to take your accounting career to the next level? A well-established and thriving manufacturing company, based in Johannesburg, is seeking a hands-on Senior Accountant to join their dynamic finance team. This is a fantastic opportunity for someone who thrives in a fast-paced, production-driven environment and is passionate about streamlining financial ...
6 days ago

Senior Financial Analyst â Equities
Location: Johannesburg
Salary:
Are you an experienced investment professional with a passion for listed property and equity markets? A leading specialist investment manager is seeking a Senior Financial Analyst to join their high-performing team.
6 days ago