Network Manager

Job Objective: Provides strategic leadership in developing, expanding, and optimizing the organization’s healthcare provider network. It drives cost efficiency, supports clinical quality, and ensures clients have reliable access to care.

The role is responsible for managing the full provider lifecycle, including credentialing, onboarding, contract negotiations, and ongoing performance audits while complying with regulatory requirements and service level agreements (SLAs).

Key Responsibilities

• Develop and implement strategies to expand and optimize the healthcare provider network in line with organizational objectives.
• Oversee provider network expansion and contract management, handling negotiations, onboarding, renewals, and agreement amendments to maintain comprehensive geographic and specialty coverage.
• Build and manage strong provider relationships to enhance service delivery and collaboration.
• Maintain an accurate and up-to-date provider directory, ensuring completeness of provider information and service coverage.
• Drive provider accountability by tracking performance metrics against established service standards, quality indicators, and contractual commitments.
• Resolve provider-related issues, complaints, and escalations promptly and professionally, while working with Claims, Medical, Customer Service, and Finance teams to address operational challenges affecting providers and clients.
• Analyze provider utilization, network adequacy, and cost trends to identify opportunities for improvement and cost optimization.
• Monitor network performance and prepare reports for senior management to support strategic decision-making.
• Ensure accurate provider records and compliance with regulatory, accreditation, and organizational standards.
• Foster a high-performance culture within the Provider Network team through active leadership and mentorship to consistently achieve departmental goals.
• Support strategic initiatives, process improvements, and technology solutions that enhance network operations.
• Perform other duties as assigned to support departmental and organizational objectives.

Required Skills & Competencies:

• Deep knowledge of healthcare administration, service delivery, operations, and provider reimbursement models.
• Excellent stakeholder engagement, relationship management, negotiation, and contract execution.
• Experience in provider network development, contract negotiation, tariff structuring, and strategic stakeholder management.
• Advanced data-driven decision-making, planning, and organizational skills with sharp attention to detail.
• Strong leadership, people management, and team development capabilities.
• Ability to prioritize effectively, meet crucial deadlines, and work well in a fast-paced organization.
• Proficient in Microsoft 365 office tools and provider management software, with a strong commitment to service excellence.

Qualification:

• Bachelor’s degree in healthcare management, Business Administration, Insurance or any related field.
• Professional certifications in Healthcare Management or Insurance will be an added advantage.
• Minimum of 6 years of relevant experience in healthcare administration, health insurance, HMO, or TPA operations, with at least 3 years in a managerial or supervisory role.

How To Apply:

Interested and qualified candidates should submit their updated CV directly to hr@afritpahealth.com with the subject line - Network Manager

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