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Health Insurance and Managed Care Contract Management

This programme prepares provider and funder teams to negotiate, structure and manage contracts between hospitals, clinics and medical schemes across African markets. Participants work through tariff structures, capitation and fee for service models, network agreements and dispute handling using realistic negotiation scenarios drawn from public and private health financing. The course helps managers protect margins while keeping patient access and contractual obligations balanced.

What you will be able to do

  • Explain the main managed care and reimbursement models used by African health funders.
  • Structure provider contracts that balance financial sustainability with patient access.
  • Negotiate tariffs, capitation rates and service level terms with schemes and insurers.
  • Manage contract performance, utilisation reviews and clinical governance clauses.
  • Resolve billing disputes and reconciliation problems between providers and funders.
  • Monitor contract profitability and renewal risk across a provider portfolio.

Course outline

  1. 01Health Financing and Managed Care Landscape
  2. 02Reimbursement and Capitation Models
  3. 03Contract Structuring and Key Clauses
  4. 04Tariff and Rate Negotiation Techniques
  5. 05Utilisation Management and Clinical Governance Terms
  6. 06Billing Reconciliation and Dispute Resolution
  7. 07Contract Performance Monitoring
  8. 08Renewal Strategy and Portfolio Review

Who should attend

This course suits contracts managers, hospital commercial managers, medical scheme relationship managers and finance leaders responsible for provider funder agreements.

Dates, venues and fees

DatesVenueDaysFeeCalendar
17 to 19 Aug 2026Nairobi3US$1,500
24 to 26 Aug 2026Durban3R13,000
31 Aug to 2 Sep 2026Johannesburg3R13,000
14 to 16 Sep 2026Mauritius3US$1,500
21 to 23 Sep 2026Dubai3US$1,500
28 to 30 Sep 2026Lagos3US$1,500
5 to 7 Oct 2026Harare3US$1,500
12 to 14 Oct 2026Kampala3US$1,500
19 to 21 Oct 2026Dar es Salaam3US$1,500
26 to 28 Oct 2026Pretoria3R13,000
2 to 4 Nov 2026Cape Town3R13,000
16 to 18 Nov 2026Online3US$900
23 to 25 Nov 2026Mozambique3US$1,500
30 Nov to 2 Dec 2026Cairo3US$1,500
7 to 9 Dec 2026Accra3US$1,500
14 to 16 Dec 2026Lusaka3US$1,500
21 to 23 Dec 2026Kigali3US$1,500

Fees are per delegate. South African venues are priced in rand; other locations and online in US dollars. Fees exclude 15% VAT where applicable. Group bookings of three or more delegates from the same organisation qualify for a reduced rate; contact us for a quotation.

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