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Provider Network Supervisor / Manager 4 views

Benoni, Gauteng
J2E Placements

A large client based in Benoni is currently looking for a Network Supervisor that has worked or is working in the Medical Aid/Medical Schemes Industry, to employ as soon as possible. Must stay within the Eastrand or close by areas.
MUST have experience in dealing with Medical Aid Schemes and Providers to be considered for this position. Must also have thorough knowledge of the Medical Schemes Act.
Salary – R25 000 – R35 000 per month plus benefits (medical insurance – company contribution is 50% if candidate does not have medical aid, group life cover – in case of death, disability and dread disease, & 5 cubed investment which is similar to a provident fund).
Purpose of the position:
Manage provider network department and Maintain service standards.
  • Matric
  • Degree in Business Management
  • 5 years+ experience in similar role
  • 5+ years Management experience managing a medium to large team
  • Knowledge of all products offered
  • Knowledge of medical insurance industry
  • Knowledge of contact centres and telephone systems
  • Demonstrable Managerial skills – must be able to supervise staff
  • Own vehicle
  • Valid driver’s licence
  • Able and willing to travel nationally
Duties include, but are not limited to:
  • Maintain Divisional Business Performance
  • Perform ad hoc Administrative Duties
  • Build and Maintain relationships with all Designated Service Providers
  • Establish, develop, and maintain business relationships with prospective and existing service providers
  • Update and maintain the scheme and benefit rules, be the main point of contact for the managed care administrator.
  • Responsible for updates to and from the business with regards to the service providers and managed care administrators
  • Responsible for maintaining service provider agreements and maintain both service provider and organisation compliance
  • Liaise and sign up with prospective service providers
  • Conduct off site visits with service providers
  • Ensure that call centre staff are trained, informed, and updated on all products and benefits
  • Manage all call centre staff day to day activities
  • Monitor and conduct performance management and performance appraisals on staff
  • Handle all escalated calls and mails
  • Oversee all training within department
  • Conduct and report on forensic investigations
  • Identify, report, and resolve any trends picked up within the department
  • Liaise with all departments to communicate business needs
  • Conduct general admin and analytical duties
  • Maintain a data base of available statistics
  • Check that providers are paid according to SLA
  • Update bank details
  • Daily, weekly, and monthly risk analysis

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