Specialist: Healthcare Provider Networks at Road Accident Fund

Key Performance Areas

Manage Healthcare Provider Network Processes

• Monitor and manage the quality of healthcare Provider Performance Networks and compliance in line with the SLA or MoU.
• Provide orientation, education, and general support for existing providers which includes conducting all face-to-face meetings and ad-hoc requests.
• Responsible for establishing and maintaining processes and systems to provide routine services to members including contract management.

Provider Administration

• Design database systems used to manage provider data.
• Resolve escalated issues arising from operations and requiring coordination with other departments.
• Design and execute on performance management processes to demonstrate network performance.

Policy Review and Implementation

• Contribute to the development and implementation of healthcare Network protocols.
• Contribute to the development and implementation of provider networks.
• Keep up to date with effective SOP’s, policy and practice execution strategies.

Reporting

• Develop reports/ policies/ procedures and guide the process through the alignment of the documents to the overall RAF’s Strategy.
• Develop functional reporting systems, for management, projects or performance reporting.
• Prepare proposals, briefings, presentations, reports, and other documentation and provide management information both verbally and in report format.

Stakeholder Management

• Facilitate and manage communication with relevant internal and external stakeholders to proactively and progressively manage the relationships.
• Manage relationships with vendors, service providers or procurement teams and ensure that all relevant procured items are invoiced and paid on time.

Qualifications and Experience

• Bachelor’s Degree/ Advanced Diploma in Clinical Sciences related qualification.
• Relevant 5 - 7 years’ work experience in the healthcare funding/ medical scheme industry of which 3 - 5 years’ experience in healthcare networks and/or provider relations is essential.