The Clinix Health Group (CHG) assists communities to live longer, healthier lives through the provision of quality and affordable healthcare. The group provides integrated world-class healthcare systems both internally and externally to the broader ecosystem as a trusted local citizen.
Job Title : Funder Relations Manager
Location : Clinix Head Office (Hyde Park)
Reports to : Group Funder Relations Manager
JOB SUMMARY
We are seeking a Senior Fund Relations Manager to lead and manage funder relations across the Group, ensuring strategic engagement with medical schemes and funders. The role is responsible for tariff negotiations, contracting, DSP status, quality reporting, and identifying new revenue opportunities. It serves as the key interface between CHG hospitals and external funders.
REQUIREMENTS
Minimum Qualifications
Bachelor's degree in clinical (Nursing or Medicine), or related field.
Must have a post graduate qualification or MBA.
Minimum Experience
7 years' experience in a Funder or Managed Healthcare environment
TECHNICAL SKILLS
SQL Server (Advanced): T-SQL, CTEs, window functions, schema design, performance tuning.
Funder relations
Medical Coding
Tariff negotiations
Effective Report Writing and Communication
Critical problem-solving ability
Advanced computer literacy
Strategic Stakeholder Management
Negotiation skills
Analytical skills
Strategic thinking and decision-making
DELIVERABLES
Strong relationship management and communication skills to build trust and maintain effective partnerships with medical schemes and claims representatives.
Negotiation skills tailored for high-stakes healthcare environments, including understanding regulatory frameworks and tariff determination processes.
Liaise with hospitals upon finalisation of contractual arrangements
In collaboration with relevant parties from hospital facilities identify improvement and growth opportunities
Escalate issues to Funders that relate to short-payments or non-compliance regarding agreed terms
Ensure that tariff changes are reflected on SAP and that Case Managers receive confirmation upon change effect
Develop proposals to the Funders based on the pricing mandate and with due consideration to funder variations
Annually adjust tariff schedules according to contractual agreements and share with Group Finance for auditing
Through IT, ensure the new tariffs are loaded on all relevant software
Lead the identification of new Funders to assess ways in which the Group can optimise revenue opportunities
Lead price negotiation with doctors and continuously assess success of product / service against revenue targets
Manage stakeholder relationships and quality of service delivery to ensure successful overall business results
Able to interpret key drivers of efficiency or inefficiency from Medical Scheme meetings and Cost Per Event reports and use these insights to engage relevant internal stakeholders for performance improvement.
Identify and implement opportunities for cost reduction and to streamline processes
Ensure good governance including the effective use of management systems to monitor compliance to business direction and policies
Drive adherence to statutory standards, policies and procedures within the business unit to ensure compliance at all times and take remedial action where necessary
* Establish, implement, monitor and audit the key business processes and metrics
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