RAF Vacancies

To apply, click on the link at the end of the posts and all the best with your applications.

Consultant: Medical Management

Division:  Claims

Reference No:  4761

Location:  

East London, Eastern Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  11

Job Posting Salary:  R501,775.00

Job Posting End Date:  2 Feb 2025

The Road Accident Fund’s mission is to provide appropriate cover to all road users within the borders of South Africa; to rehabilitate and compensate persons injured as a result of motor vehicle accidents in a timely and caring manner; and to actively promote safe use of our roads.

Note: This is a 12-month, fixed-term contract position (Re-advertisement)

Purpose of the job: The Consultant: Medical Management is responsible to implemement the medical management activities, medical exception handling and providing administration support in claims processing.

Key Performance Areas

Medical management

• Conduct medical assessment and compile injury assessment reports.
• Conduct assessments and bill reviews on submitted claims, focusing on the appropriate level of care, the length of stay, and quality of care.
• Incorporate tariffs, cost savings initiative recording, and treatment protocol to ensure that all service providers adhere to the rules, and the tariff as guided by the RAF and / or any that is considered reasonable.
• Preauthorise submitted claims aligned to RAF clinical guidelines including the RAF formulary, treatment protocols and related tariffs.
• Escalation of complex cases for multi-disciplinary review and adjudication.
• Participate in the consultations process on the implementation of medical claims processes.

Exception handling.

• Ensure the implementation and maintenance of a formal exception handling process within the medical management.
• Maintain the documentation and regular updating of the exception handling process.
• Maintain the implementation an unusual occurrence procedures.

Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.
• Produce documents, briefing papers, reports, and presentations.

Stakeholder management

• Deal with/and respond to correspondence.
• Maintain healthy relationships with all stakeholders.
• Follow up and resolve all queries, up and make recommendations on which corrective actions are appropriate.
• Follow up and feedback to all stakeholders to keep them updated on the status of a query.
• Respond to queries within the predefined turnaround times.

Qualifications

• Bachelor’s Degree/Advanced Diploma in Health Sciences /Medical related qualification.
• Registration with HPCSA/SANCA

Experience

• Relevant 3 years’ experience in a Medical related environment

Technical and behavioral competencies required

• Claims management process/ processes and systems.
• Medical product management
• Medical bill reviewing
• Medical case management
• Complex problem identification, solving and decision making
• Customer value proposition
• Strong clinical analytical capabilities
• Knowledge of motor vehicle accident legislation
• Planning, Organising and Coordinating.
• Personal Mastery.
• Judgement and Decision Making.
• Ethics and Values.
• Client Service Orientation.

NB: “RAF offers Total Employment Cost packages with no additional contributions from the Employer, successful candidates are required to structure their packages in a manner that will suit their needs.”

The Road Accident Fund subscribes to the principles of employment equity and preference will be given to People with Disabilities.

Applicants who have not received any correspondence from us within six weeks from the closing date can consider themselves unsuccessful

Security Vetting shall be conducted on all prospective employees

It is the applicants’ responsibility to have foreign qualification evaluated by the South African Qualification Authority (SAQA) and to provide proof of such evaluation.

Manager: Business Support

Division:  Corporate Support

Reference No:  4941

Location:  

Centurion, Gauteng, ZA

Employment Type:  Permanent

Disability (EE targeted role):  No

T.A.S.K Grade:  15

Job Posting Salary:  R891,176.00

Job Posting End Date:  5 Nov 2024

The Road Accident Fund’s mission is to provide appropriate cover to all road users within the borders of South Africa; to rehabilitate and compensate persons injured as a result of motor vehicle accidents in a timely and caring manner; and to actively promote safe use of our roads.

Purpose of the Job: Reporting to the Senior Manager: Facilities Management, the successful incumbent is accountable to manage the Business support function in ensuring that the Facilities administrative processes relating to the RAF office buildings are maintained.

Key Performance Areas

Policy review and implementation

• Contribute to the development and implementation of departmental policy, procedures and processes.
• Keep up to date with effective policy and practice execution strategies.

Management of communal asset

• Monitor the maintenance of communal fixed asset register nationally (structure, standard descriptions, correct asset classes, location structure etc).
• Manage communal asset disposals. process.
• Advise Logistics Department on assets that need to be removed from the communal Asset Register due to being lost, stolen or damaged beyond economical repair.
• Compile and execute monthly and annual Facilities Management communal asset verification nationally.

Contracts

• Contribute Management of all facilities management service contracts nationally and provide updates on a monthly basis.
• Manage new and renewal of lease agreements from a facilities management point of view.
• Ensure that contracts are in place for all facilities management related services and leased properties.
• Monitor and coordinate the submission of contract performance reviews on a quarterly basis.

Financial Services

• Ensure Support of payment authorizations for the payment of Facilities Management services and accounts.
• Quality assure report on accounts submitted for payments, analyse variance reports and follow up on accounts not yet paid.
• Manage the complilation of variance reports on a monthly basis.
• Manage the verification of monthly actual expenses against limits on line items.
• Review monthly journal entries and reconciliations.
• Ensure that month end and year journals and procedures are finalised on time as prescribed by Finance.
• Monitor the monthly budget verses actual expenditure, verify that costs where correctly allocated.
• Consolidation of budget requirements for FM nationally for annual budget submission incive to budget shifts.

Reporting

• Prepare and submit reports as and when required to provide progress updates and/or inform management decisions.
• Prepare proposals, briefings, presentations and any other required documentation and provide management information both verbally and in report format.

Stakeholder Management

• Facilitate and manage communication with relevant internal and external stakeholders and progressively manage the relationships.
• Manage relationships with vendors, service providers or procurement teams and ensure that all relevant procured items are invoiced and paid on time.
• Communicate with all levels of stakeholder contact.
• Represent the Fund in relevant external activities and events.

People Management

• Ensure the sourcing, development and retention of a high-performance team.
• Manage the recruitment of the operational workforce in line with employment equity targets.
• Manage staff in the department to ensure that they achieve their objectives in line with the strategic objectives of the RAF.
• Manage the implementation of human capital processes and procedures to control/regulate workplace conflict and/or institute corrective measures and consultation processes to address deviations from standards.
• Allocate, direct, motivate and evaluate subordinates to help them achieve their individual goals.

Qualifications and Experience

• Bachelor’s Degree/Advanced Diploma in Facilities Management related qualification.
• Postgraduate qualification in Facilities Management related qualification advantageous.
• Relevant 6-8 years’ experience in Facilities management related environment of which 2 years must have been on supervisory level/management level/area of expertise.

Technical and Behavioral Competencies Required

• Strategic capability and leadership.
• Resilience.
• Communication.
• Working with People
• Network and Alliances.
• Planning, Organising and Coordinating.
• Employee Engagement.
• Personal Mastery
• Judgement and Decision Making
• Ethics and Values
• Client Service Orientation
• Change management.
• Coaching and mentoring.
• Conflict management.
• Critical and innovative thinking.
• Direction setting.
• Facilitation and Presentation Skills.
• People management.
• Policy conceptualisation and formulation.
• Risk Management.
• Programme/project management.
• Service Delivery Innovation.
• Stakeholder development and relations.
• Reporting.
• Computer literacy (Windows, including – Advanced Excel), Microsoft Outlook.
• Excellent Knowledge of SAP (Asset Management, MM and PM).
• Knowledge and understanding of PFMA, IFRS.
• Knowledge and understanding of legislation applicable to asset management.
• Computer literacy and knowledge of SAP (asset management), excellent skills in MS Excel and Word.
• Ability to formulate strategies through analytical and innovative thinking.
• Knowledge of Financial management and PFMA.

The Road Accident Fund subscribes to the principles of employment equity and preference will be given to People with Disabilities.

Applicants who have not received any correspondence from us within six weeks from the closing date can consider themselves unsuccessful

Security Vetting shall be conducted on all prospective employees

It is the applicants’ responsibility to have foreign qualification evaluated by the South African Qualification Authority (SAQA) and to provide proof of such evaluation.

Click here to apply

We wish you all the best with your applications