Manager – Hospital Network and Relations

Position:
Manager – Hospital Network and Relations

Location: Centurion, Gauteng

Position

Purpose:

We are seeking a highly skilled and dynamic Manager:
Hospital Network to lead and optimise our hospital provider network across South Africa. In this key leadership role, you will be responsible for managing relationships with hospital groups and facilities, supporting hospital contracting, analysing performance, and driving initiatives that enhance quality, affordability, and access to care for our members.

If you excel at building partnerships, interpreting complex data, and improving healthcare outcomes, this is the ideal opportunity to make a measurable impact.

Experience & Qualifications
:

Degree or Diploma in Health Sciences, postgrad in Healthcare Management, Business Management, or related field will be advantageous

• 5–7 years of experience in hospital provider management, healthcare networks, managed care, or medical scheme operations.
• Strong understanding of private hospital groups, facility operations, and reimbursement models (e.g., DRGs, global fees).
• Experience in analysing hospital claims and utilisation data.
• Leadership or supervisory experience (advantageous).

Hospital Network Management:

• Implement and oversee the hospital network strategy across private hospital groups and independent facilities.
• Conduct hospital adequacy assessments and support network expansion opportunities.
• Support the rollout of DSP hospital arrangements, tiered networks, and Centres of Excellence.

Hospital Relationship & Stakeholder Engagement:

• Serve as the primary point of contact for hospital management teams.
• Resolve escalations, including billing disputes, clinical queries, authorisation concerns, and operational issues.
• Facilitate engagement sessions, performance reviews, and education initiatives with hospital partners.

Contracting & Compliance Support:

• Prepare negotiation data packs, tariff analyses, and SLA performance insights.
• Manage contracting workflows, including documentation, e‑contracting processes, and version control.
• Ensure hospitals understand and adhere to contractual terms, quality metrics, and reimbursement models.

Digital Enablement:

• Promote adoption of hospital digital systems, including e‑authorisation, digital contracting, and clinical information tools.
• Troubleshoot hospital system issues and work with IT/digital teams for resolution.
• Track and improve hospital digital utilisation.

Performance Monitoring & Quality Analytics:

• Monitor key hospital performance indicators, including LOS, readmission rates, high‑cost cases, and theatre utilisation.
• Produce dashboards and reports to support performance improvement and cost‑containment.
• Identify performance risks and implement corrective interventions.

Leadership & Team Development:

• Ensure adherence to CMS regulations, PMBs, POPIA, and internal governance.
• Maintain audit‑ready documentation and accurate records.
• Escalate risks, non-compliance trends, and provider‑related issues.
• Excellent relationship and stakeholder management skills.
• Strong analytical and data interpretation ability.
• Good understanding of PMBs, coding (ICD‑10, CPT), tariffs, and clinical protocols.
• Exceptional communication and negotiation skills.
• High attention to detail and governance discipline.
• Proficiency with BI tools, Excel, and hospital digital systems.

Note:
Company reserves the right to close the advert before specified closing date.

PHA has its head office in Westville, Kwa Zulu-Natal. It operates country-wide with a nationally linked network and uses a robust, flexible, as well as integrated system to ensure efficient and effective administration of membership and benefits.