The Road Accident Fund (RAF) invites suitably qualified applicants to apply for their Medical Management Consultant Vacancies (X27 Posts). The closing date for applications is the 28th October 2025
POSITIONS: CONSULTANT: MEDICAL MANAGEMENT X27
JOB TYPE: 3 YEAR FIXED TERM CONTRACT
QUALIFICATIONS & EXPERIENCE:
Qualification
- Bachelor’s Degree/Advanced Diploma in Health Sciences/Medical related qualification.
- Registration with HPCSA/SANCA.
- Relevant 3 years’ experience in A Medical related environment.
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.
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.
Technical and behavioral competencies required
- Claims management process/processes and systems.
- Medical product management.
- Medical bill reviewing
- Medical case management
CLICK HERE TO APPLY FOR THE CONSULTANT: MEDICAL MANAGEMENT X27
CLOSING DATE: 28 OCTOBER 2025
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