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ROAD ACCIDENT FUND (RAF)
 


Note: THIS IS A THREE (3) YEAR FIXED TERM CONTRACT
 
Purpose of the Job: The Consultant: Medical Management is responsible to implement 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.
  • Pre-authorise 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 making 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 and Experience
  • Bachelor’s Degree/Advanced Diploma in Health Sciences/Medical related qualification.
  • Registration with HPCSA/SANCA.
  • Relevant 3 years’ experience in A Medical related environment.
 

Technical Competencies Required
  • Claims management process/processes and systems.
  • Medical product management.
  • Medical bill reviewing
  • Medical case management
 
Behavioural Competencies Required
  • Planning, Organising and Coordinating
  • Personal mastery
  • Judgment 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.
 
PLEASE APPLY HERE









​MANAGER: OCCUPATIONAL HEALTH & SAFETY
Division:  Corporate Support
Reference No:  5885
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: 16 Sep 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.
 
Purpose of the Job: Reporting to the Senior Manager: Facilities Management, the successful incumbent is accountable to manage and drive Occupational Health and Safety (OHS) for the organisation to ensure compliance.
 
Key Performance Areas
 
Implement Minimum Safety Standards in Line with the Occupational Health and Safety Act
  • Oversee risk assessment in order to develop prevention strategy and program.
  • Liaise with Fire Department, Disaster Management Centre and SAPS on evaluation and endorsement of the operational emergency Plan.
 
Manage OHS Plan
  • Develop OHS awareness strategy for the RAF.
  • Conduct OHS awareness campaigns for the RAF.
  • Conduct threat/ risk analysis and recommend proactive and reactive plans.
  • Manage the provision of OHS Training.
  • Review and update contingency plan on annual basis.
 
Manage Incident and Accident Investigations
  • Conduct accident and incident investigations. 
  • Analyze accident and incident reports and develop improved measures. 
  • Provide reports for all incidences to the relevant stakeholders.
  • Manage record keeping of all OHS accident and incidence.
 
 Policy Review and Implementation
  • Develop and manage the implementation of Occupational  Health and Safety (OHS) plans and systems for the RAF.
  • Provide advice and guidance to the RAF on emerging issues, risks, and the implementation of changes required and insights on policy matters.
  • Develop and review contingency planning procedure.
 
Reporting
  • Develop functional reporting systems, for management, project or performance reporting.
  • Ensure regular and periodic reports are reviewed and submitted as and when required to provide progress updates and/or inform management decisions.
 
Stakeholder Management
  • Maintain proactive and progressive relationships with key stakeholders.
  • Deal with inquiries and requests for information from both internal and external stakeholders.
  • Manage relationships with service providers or procurement teams and ensure that all relevant procured items are invoiced and paid on time.
 
People Management
  • Management of human capital processes and procedures to control/ regulate workplace conflict and/or institute corrective measures and consultation processes to address deviations from standards.
 
Qualifications and Experience
  • Bachelors Degree in Occupational Health and Safety related qualification. 
  • Post Graduate Degree in Occupational Health and Safety related qualification advantageous.
  • Relevant 6 - 8 years’ experience in Occupational Health and Safety related environment of which 2 years must have been on a management level/ Supervisory level/ area of expertise.
 
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.
 
PLEASE APPLY HERE