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

Officer: Occupational Health & Safety

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Location:  

Centurion, Gauteng, ZA

Employment Type:  Permanent

Disability (EE targeted role):  No

T.A.S.K Grade:  11

Job Posting Salary:  R501,775.00

Job Posting End Date:  10 Sep 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 Manager: Occupational Health and Safety, the successful incumbent is accountable to provide for the health and safety of persons at work and for the health and safety of persons in connection with the use of plant and machinery, the protection of persons other than persons at work against hazards to health and safety arising out of or in connection with the activities of persons at work.

Key Performance Areas

Contribute to OHS Strategies

• Contribute to the development and maintenance of OHS strategy.
• Proactively promote the OHS of all employees, visitors and contractors.
• Develop and maintain the OHS and safety strategies through facilitation.
• Development of effective codes and standards to address occupational health and safety hygiene.
• Analyse and compile OHS  reports.
• Develop and implement National Occupational Disease prevention programme.

OHS and Contingency Planning

• Conduct threat or risk analysis and recommend proactive and reactive plans.
• Conduct fire risk assessment in order to develop fire prevention strategy and program.
• Develop and implement contingency plan.
• Participate in emergency management committee and organize such meetings.
• Liaise with fire department, disaster management centre and SAPS on evaluation and endorsement of the contingency plan.
• Review and update contingency plan on annual basis.
• Co-ordinate emergency or fire drill evacuation at least once a year.

Conduct OHS Special Investigations and Reporting

• Investigate all OHS incidences.
• Report all incidences to Facilities/OHS and Administration Manager.
• Record all OHS incidences to incident register.
• Conduct incident investigations on reportable incidents.

Perform OHS Audits

• Participate in establishing OHS audit schedule.
• Conduct internal audits, workplace inspections and investigate complaints.
• Analyse trends and feedback obtained through incident or audit reports.

Workers Compensation or Injury Management

• Ability to maintain confidentiality at all times.
• Process workers Compensation claims.
• Liaise with rehabilitation specialists, HR and EWS to ensure documentation and application of rehabilitation procedures are followed.
• Conduct incident and accident investigations and compile a report
• Participate in the review of relevant policies and procedures.

OHS Champion Management

• Ensure OHS committee members attend meetings.
• Train OHS or committee members & employees and conduct awareness programs.
• Ensure that tasks are being performed and that the representatives follow the correct procedures.
• Training of all personnel to ensure that they are aware of their functions.
• Ensure monthly meetings with organised labour and Committee Chairpersons to discuss OHS matters.

Qualifications and Experience

• Bachelor’s Degree/ Advanced Diploma in Occupational Health and Safety related qualification.
• Certificate in First aid training.
• Certificate in Firefighting training.
• Certificate in SAMTRAC would be an added advantage.
• Relevant 3 years working experience in Occupational Health and safety related environment.
• Experience of the OHS Act, SABS and ISO 2001 regulations.

RAF Attorney: High Court x2 Kimberley

Division:  Governance

Reference No:  4768

Location:  

Kimberley, Northern Cape, ZA

Employment Type:  Permanent

Disability (EE targeted role):  No

T.A.S.K Grade:  16

Job Posting Salary:  R1,028,791.00

Job Posting End Date:  10 Sep 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: The RAF Attorney: High Court is responsible for all High Court matters within the Fund and to offer litigation services accordingly. This role will also be responsible to perform a range of tax services including tax bill of costs in compliance with South African laws and regulations.

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.

Preparation and Research on Related Litigation Matters

• Conduct research that will provide information in preparation for all matters for trial.
• Consult with client departments/ representatives, and witnesses for instructions and documentation for cases to be presented in Court.
• Draft pleadings to provide clear motivation/justification on a particular position about the case.

Mediation Process

• All required steps regarding the mediation process, as governed by the amendment to the rules of court, are to be taken.
• Upon conclusion of the mediation, parties shall inform Registrar and all other parties by a notice that Mediation is completed.
• Parties & Mediator must within 5 days of completion of mediation issue a joint minute indicating.

Represent the Road Accident Fund on all third party claims related litigation matters

• Attend court appearances in all allocated third-party litigation matters.
• Ensure file administration from opening to the conclusion of a legal case including adherence to trial dates.
• Handle appearances at courts, tribunals, mediation hearings and inquiries.
• Coordinate administrative legal actions to ensure compliance.
• Approve instructions to appoint and instruct expert witnesses.

Settle non-litigious matters before they are set down for trial

• Block consultation, early assessment of files, and early instructions to experts and assessors.
• Approve requests to appoint and instruct assessors and expert witnesses. 
• Recommend a settlement.

Provision of legal advice to RAF

• Provide legal advice on arising legal matters and contracts.
• Provide well-researched legal advice on matters impacting the organisation.
• Conduct legal research and prepare legal opinions.

Taxation

• Deliver a full range of tax services in compliance with laws and regulations.
• Build relationships and interact with clients to provide consulting and expertise in tax services.
• Provide innovative tax planning and review complex income tax returns

 Reporting

• Prepare and submit regulation  reports as and when required to provide progress updates and/or inform management decisions.
• Develop reports/ policies/ procedures and guide the process through the alignment of the documents to the overall RAF’s Strategy.
• Develop functional reporting systems, for management, projects or performance reporting.
• Prepare proposals, briefings, presentations, reports, and other documentation and provide management information both verbally and in report format.

Stakeholder Management

• Facilitate and manage communication with relevant internal and external stakeholders in relation to investments and proactively 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.

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

• Bachelor’s Degree in Law or equivalent.
• Postgraduate in Law or equivalent.
• Admission as an Attorney of the High Court or Advocate.
• Right of appearance in the High Court.

Experience

• Relevant 5-7 years legal experience post-graduation or admission of which 2 years must have been on area of expertise (personal injury litigation)

• Behavioural
  • 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                                                                                                                                                  
• Managerial
  • 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
• Technical
  • Legislation & regulatory knowledge
  • Ethics & compliance
  • Monitoring and evaluation
  • Policy and standard
  • Governance
  • Claims litigation
  • MVA law and legislation
  • Negotiation
  • Conflict resolution
  • Problem solving and analysis
  • Mediation

RAF Attorney: High Court – Cape Town, Western Cape, ZA

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RAF Attorney: High Court

Division:  Governance

Reference No:  4770

Location:  

Cape Town, Western Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  16

Job Posting Salary:  R1,028,791.00

Job Posting End Date:  10 Sep 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.

Note: This is a 3-Year Fixed Term Contract

Purpose of the Job: The RAF Attorney: High Court is responsible for all High Court matters within the Fund and to offer litigation services accordingly. This role will also be responsible to perform a range of tax services including tax bill of costs in compliance with South African laws and regulations.

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.

Preparation and Research on Related Litigation Matters

• Conduct research that will provide information in preparation for all matters for trial.
• Consult with client departments/ representatives, and witnesses for instructions and documentation for cases to be presented in Court.
• Draft pleadings to provide clear motivation/justification on a particular position about the case.

Mediation Process

• All required steps regarding the mediation process, as governed by the amendment to the rules of court, are to be taken.
• Upon conclusion of the mediation, parties shall inform Registrar and all other parties by a notice that Mediation is completed.
• Parties & Mediator must within 5 days of completion of mediation issue a joint minute indicating.

Represent the Road Accident Fund on all third party claims related litigation matters

• Attend court appearances in all allocated third-party litigation matters.
• Ensure file administration from opening to the conclusion of a legal case including adherence to trial dates.
• Handle appearances at courts, tribunals, mediation hearings and inquiries.
• Coordinate administrative legal actions to ensure compliance.
• Approve instructions to appoint and instruct expert witnesses.

Settle non-litigious matters before they are set down for trial

• Block consultation, early assessment of files, and early instructions to experts and assessors.
• Approve requests to appoint and instruct assessors and expert witnesses. 
• Recommend a settlement.

Provision of legal advice to RAF

• Provide legal advice on arising legal matters and contracts.
• Provide well-researched legal advice on matters impacting the organisation.
• Conduct legal research and prepare legal opinions.

Taxation

• Deliver a full range of tax services in compliance with laws and regulations.
• Build relationships and interact with clients to provide consulting and expertise in tax services.
• Provide innovative tax planning and review complex income tax returns

 Reporting

• Prepare and submit regulation  reports as and when required to provide progress updates and/or inform management decisions.
• Develop reports/ policies/ procedures and guide the process through the alignment of the documents to the overall RAF’s Strategy.
• Develop functional reporting systems, for management, projects or performance reporting.
• Prepare proposals, briefings, presentations, reports, and other documentation and provide management information both verbally and in report format.

Stakeholder Management

• Facilitate and manage communication with relevant internal and external stakeholders in relation to investments and proactively 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.

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

• Bachelor’s Degree in Law or equivalent.
• Postgraduate in Law or equivalent.
• Admission as an Attorney of the High Court or Advocate.
• Right of appearance in the High Court.

Experience

• Relevant 5-7 years legal experience post-graduation or admission of which 2 years must have been on area of expertise (personal injury litigation).

Behavioural

• • 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

Managerial

• • 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

Technical

• • Legislation & regulatory knowledge
  • Ethics & compliance
  • Monitoring and evaluation
  • Policy and standards
  • Governance
  • Claims litigation
  • MVA law and legislation
  • Negotiation
  • Conflict resolution
  • Problem solving and analysis
  • Mediation

Road Accident Fund Values

• Integrity
• Compassion
• Accountability
• Respect
• Excellence
• Empathy

Senior Officer: Field Case Management x2

Division:  Claims

Reference No:  3902

Location:  

Cape Town, Western Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  Yes

T.A.S.K Grade:  12

Job Posting Salary:  R579,259.00

Job Posting End Date:  10 Sep 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.

Job Title: Senior Officer: Field Case Management X2

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 6 Months Fixed Term Contract

Purpose of the Job:  To manage the rehabilitation and health care needs of the injured.

Key Performance Areas

 Decision making regarding quality of care.

• Assessment of ongoing medical problems of the injured after discharge in the home environment.
• Assessment of patient according to prescribed measurements.
• Assessment of burden of care and needs of the client.
• Monitors of quality of care issues
• Selection and monitoring clinical pathways.

 Decision Making regarding collaboration.

• Facilitates collaboration of service providers with client.
• Protector of privacy and confidentiality.
• Coordination of plan of care and services.
• Facilitate caregiver’s appointments necessary for the client.
• Facilitate timely consultation with appropriate medical service providers.
• Facilitate family and clinical team communication.
• Health educator and counsellor for client and family.
• Utilization review.
• Post discharge follow-through.

Decision making regarding advocacy criteria.

• Conflict resolution expert and referee.
• Liaison between patient and care team.
• Negotiating and procuring resources and services from providers.
• Benefit analysis.
• Record keeping and documentation.
• Maintain patient confidentiality.

Decision making regarding resource utilization.

• Post discharge follow-through.
• Drug utilization review.
• Assistive devices necessary for client.
• Home alterations.
• Vehicle adaptations.
• Vocational guidance after life changing event for client.
• Placement of children in special schools.
• Back to work opportunities.

Decision making regarding legal & ethical criteria.

• Advise client of accident relatedness of his claim.
• Decide reasonableness and appropriateness of service.
• Advise whether altering homes and placing clients in rehab centres or institutions is appropriate.
• Advice regarding payment of care givers taking into account patient autonomy, informed choice, medical implications and burden of care.

Pre-authorisation of admissions.

• Arrange for hospital admission and advise patients on their benefit.

Assess medical Bills.

• Assessment of bills received and advise claimants of outcomes of bill review.

Recommend payment.

• Recommend payment of bills assessed.

Qualifications

• Bachelor’s degree or Advanced Diploma in Nursing/ Allied Health Professions or related qualification.
• Registration with the relevant Health professions council.
• Knowledge of ICD and CPT coding will be an advantage.
• Valid code 8 driving license.

Experience

• Relevant 4 years’ experience in the medical field of which 1 year is on supervisory level.
• Experience in Managed health.

Competencies

Behavioural.

•  Organisational Resilience.
• Team Resilience.
• Network and Alliances
• Personal Mastery.
• Judgement and Decision Making.
• Emotional wisdom
• Ethics and Governance.
• Customer orientation and Customer Focus.

Technical.

• People orientated.
• Team player.
• Adaptability, flexibility, and creativity.
• Interpersonal & communication skills.
• Strong sense of self-esteem and confidence.
• Good follow-through
• Self-directedness.
• Caring attitude and behavior
• Assertiveness skills
• Analytical skills

Officer: Bill Review X4

Division:  Claims

Reference No:  3904

Location:  

Cape Town, Western Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  Yes

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  10 Sep 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.

Note: This is a 6 Months Fixed Term Contract

Purpose of the Job:  Review Medical Bills.

Key Performance Areas

Audit & review medical bills.

• Analysis of claimed items/services in correlation with available tariff structures and ICD 10 /CPT 4 codes.
• Requesting motivation for unreasonable accounts.
• Line by line analysis of claim items/service. Matching those appropriate tariffs/ICD/CPT codes.
• Flagging rejected items/services.
• Recommendations to department responsible for processing payments.
• Auditing medical claims and assisting in technical aspects of bill review.
• Ensure that accounts submitted to the Fund from service providers are valid in terms of RAF guidelines and the Road Accident Fund Act.
• Assess and monitor claims to curb over servicing or abuse and fraudulent claims.
• Ensuring that the accounts are paid timeously according to the service level agreements.
• Ensure that the services and treatments claimed are accident related/ (related to the accident under consideration).
• Reduce future healthcare cost and improve efficiencies by analysing trends in in injured person’s use of services.
• Compare outcomes and cost of different therapeutic modalities and surgical techniques and the information provided.
• Manage future healthcare costs and improve efficiencies by analysing trends in utilization of services.
• Formal assessment of medical necessity and appropriateness of procedures the will be in effective in curbing fraud and over servicing unreasonable demand of benefits from victims of road accidents.

Promote good working relations with Stake Holders.

• Check and advise on the tariffs used on accounts.
• Provided training on new developments.

Approve medical expenses in accordance with relevant DOA.

• Authorisation in accordance with mandate.
• Inform service provider of payment decision.

Assisting in technical aspects of bill review.

• Develop and manage relationships with department of health services, government dept and other key external stake holders.

.

Check & approve Payments in terms of DOA.

• Receive invoices and check payment request for accuracy and correctness.

Determine the level of care based on functional ability.

• Analysis of medical data available e.g. Case Manager’s Reports, Clinical Records and Medico – Legal Reports.

Pre authorisation of procedures.

• Analyse medical data to determine the need for the service.
• Timeous assessment of urgent files e.g. Road Shows.

Qualifications

• Bachelor’s Degree or Advanced Diploma in nursing/ Allied Health Professions or related qualification 
• Registration with the relevant Health professions council.

Experience

• Relevant 3 years’ experience in a medical field.

Competencies

Behavioural:

• Personal mastery
• Emotional Wisdom.
• Ethics and Governance.
• Customer orientation and customer focus.

Technical:

•  Computer literacy.
•  Ability to interpret the rules of the UPFS tariffs.
•  Analytical skills.
•  Organisational & Administrative skills
•  Planning and Organising
•   Decision making
•  Negotiation skills.

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”

Consultant: Funeral Adjudication

Division:  Claims

Reference No:  4741

Location:  

East London, Eastern Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  10 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Consultant: Funeral Adjudication is responsible for the processing and adjudication of funeral product claim.

Key Performance Areas

Funeral adjudication

•     Review the claim against the funeral adjudication standards.

•     Apply funeral benefit adjudication rules to determine quantum.

•     Generate funeral product offer using relevant offer template.

•     Obtain approval in line with DOA.

•     Research, analyse, and review policies and laws relevant to assigned cases.

•     After approval,  communicate the offer to the claimant through offer management.

Quality assurance

•     Participate in the consultations process on the implementation of claims and related processes.

•     Ensure that claims and processes are implemented and maintained to the highest standards.

•     Maintain the implementation an unusual occurrence procedures.

•     Quality assure the funeral adjudication claims before they can be progressed to the next phase of the

      claims processing.

Administrative support

•     Deal with/and respond to correspondence.

•     Produce documents, briefing papers, reports, and presentations.

•     Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Reporting

•     Track and report against set objectives and targets.

•     Report on emerging risks.

•     Provide ad hoc reports on process improvement initiatives.

Stakeholder management

•     Maintain healthy relationships with all stakeholders.

•     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 a related qualification.

Experience

•     Relevant 3 years’ experience in a claims adjudication related environment.

Technical and behavioral competencies required

•     Claims management process/ processes and systems.

•     Complex problem identification, solving and decision making.

•     Customer value proposition

•     Good financial management skills

•     Strong analytical capabilities

•     Knowledge of Motor Vehicle Accident legislation

•     PFMA knowledge

•     Planning, Organising and Coordinating

•     Personal Mastery

•     Judgment and Decision Making

•     Ethics and Values

•     Client Service Orientation

Administrator: Summons

Division:  Governance

Reference No:  4758

Location:  

East London, Eastern Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  08

Job Posting Salary:  R326,151.00

Job Posting End Date:  10 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Administrator (Summons) is responsible for the provision of administrative, operational, and technical support services to the respective department.

Key Performance Areas

Summons management

• Receive summonses.
• Conduct duplicate search for duplicate summonses already issued.
• Peruse particulars of claim to determine the reason for the summons.
• Instruct state attorney or ILD to enter appearance to defend.
• Arrange extension of the dies on Internal summonses for legal costs, prescription, payment of outstanding capital.
• Update, maintain records and filling system on summons.

Compliance administration

Administer applicable standards, processes, and procedures

• Maintain version control on documentation related to the departments business activities.
• Ensure compliance to the policies and process standards.
• Keep abreast of internal standards and business goals to ensure adherence to sound internal control.

Office coordination

• Maintain strict confidentiality in all matters relating to the office.
• Make follow-ups on outstanding matters and escalate where required.
• Ensure all office requests are handled and responded to within set timelines.
• Ensure availability of stationery within the department.
• Compile and distribute relevant statistics and  reports as per pre-defined standard as required.
• Coordinate operational office activities to ensure efficiency and compliance on the provision of the core function of the respective department.

Meeting support

• Provide support in setting up meetings.
• Take minutes and distribute these in accordance to set governance standards.
• Maintain follow-up plan on meeting resolutions and matters outstanding.
• Ensure confirmation of meetings and management of team diaries.
• Schedule appointments with internal and external stakeholders as and when required.

Financial and procurement processes administration

• Compile and follow up on requisitions with any procurement processes until finalised.
• Maintain the stock register for the department.
• Ensure timeous payment of invoices.
• Provide administrative support to all the departmental activities related to the SCM processes.

Document control

• Ensure that the filing system is up-to-date and functional.
• Manage the retrieval of information at all times as requested in the office.
• Ensure confidentiality of all documents under control and that documentation reaches the intended recipients.
• Acknowledge the receipt of documentation, apply a file number allocation, record data onto the computer system and file appropriately.
• Update and maintain assets register and inventory for the department.
• Maintain records of all files, correspondences, and registers.

Qualifications

• National Diploma in Office Administration/Business Management/ related or respective discipline qualification.

Experience

• Relevant 2 years’ experience in an administrative or similar environment.

Technical and behavioral competencies required

• Computer literacy in MS Word, Excel, PowerPoint.
• Excellent planning and organisational skills.
• Good administrative skills.
• Ability to access required information.
• Writing skills.
• Basic understanding of SCM processes.
• Basic financial acumen.
• Planning, organisation and coordinating.
• Personal mastery.
• Emotional wisdom and  decision making.
• Ethics and values.
• Client service orientation

Consultant: Medical Management (x2)

Division:  Claims

Reference No:  4756

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:  501 775

Job Posting End Date:  10 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Consultant: Medical Management is responsible to implememt 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.
• Pririotise 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.

Officer: Occupational Health & Safety

Division:  Corporate Support

Reference No:  4764

Location:  

Durban, Kwazulu-Natal, ZA

Employment Type:  Permanent

Disability (EE targeted role):  No

T.A.S.K Grade:  11

Job Posting Salary:  R501,775.00

Job Posting End Date:  17 Sep 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: The Officer: Occupational Health and Safety is accountable to provide for health and safety of persons at work and for the health and safety of persons in connection with the use of plant and machinery, the protection of persons other than person at work against hazards to health and safety arising out of or in connection with the activities of persons at work.

Key Performance Areas

Contribute to OHS strategies

• Contribute to the development and maintenance of OHS strategy
• Proactively promote the OHS of all employees, visitors and contractors.
• Develop and maintain the OHS and safety strategies through facilitation.
• Development of effective codes and standards to address occupational health and safety hygiene.
• Benchmark and research.
• Analyse and compile OHS  reports.
• Write executive OHS summaries.
• Develop and implement National Occupational Disease prevention programme

OHS and Contingency Planning

• Conduct threat/ risk analysis and recommend proactive and reactive plans.
• Conduct fire risk assessment in order to develop fire prevention strategy and program.
• Develop and implement contingency plan.
• Participate in emergency management committee and organize such meetings.
• Liaise with fire department, disaster management centre and SAPS on evaluation and endorsement of the contingency plan.
• Review and update contingency plan on annual basis.
• Co-ordinate emergency/ fire drill evacuation at least once a year.

Conduct OHS special investigations and reporting

• Investigate all OHS incidences.
• Report all incidences to Facilities/OHS and Administration Manager.
• Record all OHS incidences to incident register.
• Conduct incident investigations on reportable incidents

Perform OHS audits

• Participate in establishing OHS audit schedule.
• Conduct internal audits, workplace  inspections and investigate complaints.
• Regularly evaluate the risks associated with  business activities.
• Analyse trends and feedback obtained through incident/ audit reports.

Workers compensation/injury management

• Ability to maintain confidentiality at all times.
• Process workers Compensation claims.
• Liaise with rehabilitation specialists, HR and EWS to ensure documentation and application of rehabilitation procedures are followed.
• Conduct incident and accident
• investigations and compile a  report
• Education, training and induction of all employees.
• Participate in the review of relevant policies and procedures.

OHS Champions management

• Ensure OHS committee members attend     meetings
• Train OHS/ committee members & employees and conduct awareness programs.
• Ensure that tasks are being performed and that the representatives follow the correct procedures.
• Training of all personnel to ensure that they    are aware of their functions.
• Ensure monthly meetings with organized  labour and Committee Chairpersons to discuss OHS matters.

Qualifications and Experience

• Bachelor’s Degree in Occupational Health and Safety related qualification.
• Certificate in First aid training
• Certificate in Firefighting training
• Certificate in SAMTRAC would be an added advantage
• Relevant 3 years working experience in Occupational Health and safety related environment
• Experience of the OHS Act, SABS and ISO 2001 regulations

Behavioral Competencies

• Planning, Organising and Coordinating
• Personal Mastery
• Judgement and Decision Making
• Ethics and Values
• Client Service Orientation

Technical Competencies

• Computer Literate
• Good report writing and business writing skills,
• Good analytical, problem solving and decision-making skills

Specialist: Network & Security Operations

Division:  Strategy and Transformation

Reference No:  4726

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:  17 Sep 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 Manager: Network and Telecoms Operations, the successful incumbent will be accountable for the setup, configuration and management of the network environment including identifying requirements, installing upgrades, monitoring network performance. Ensure availability of a stable, reliable and secure network infrastructure (LAN, WAN, SDWAN, RAS/Mobile, Wireless connectivity). Ensure availability and network protection against intrusion or malicious activities. Team up with all Technology & Digital team members and system owners to ensure a smooth functioning of RAF network services.

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.

Network planning, design and administration.

• Plan and maintain connection to/ from different sites (WAN)
• Plan and maintain LAN within a Branch.
• Plan and maintain of backup links
• Planning and design of new branches and offices
• Design and implementation of remote access solutions.

Network Installation/Configuration

• Installation of Network Equipment (Cabinets, routers, switches)
• Installation of RAS networking
• Installation of wireless networking
• Installation of network software Firmware)
• Setup of network management server (adding/ removing of network items on management database)
• Setup of QOS (quality of service) on links using layer for switching
• Network Protocols

Network Monitoring

• Monitor WAN/LAN (links, usage, updown times, availability)
• Engage network providers when the network lines are down
• Monitor internet Links
• Monitor backup links
• Monitor network traffic
• Monitor Firewall logs

Network uptime and availability

• Prepare Implement and maintain network redundancy and virtualization
• Ensure network components and configuration information is backed up regularly
• Ensure sufficient capacity and forecasting.

Firewall and Infrastructure security related services

• Manage and configure Firewall and all Infrastructure security tools.
• Activate firewall logs on the firewall tools and extract them for further analysis by ICT Security team.
• Identify unused firewall rules for cleanup.
• Install and configure network security infrastructure devices.

Ensure that change management and governance processes are adhered to

• Adhere to the IT change management methodology for RAF.
• Develop test plans for the proposed solution.
• Implement network changes in line with best practices and set policies/standards/procedures
• Monitor and  report any discrepancies on the network implemented changes.

Stakeholder management

• Facilitate and manage  communication with relevant internal and external stakeholders and proactively and progressively manage the relationships.
• Communicate with all levels of stakeholder contact.
• Represent the Fund in relevant external activities and events.

Reporting

• Track and prepare the project status report on the progress of the implementation of reporting requirements.
• Analyse the incidents & assist network administrator to prepare incident analysis report.
• Develop reports/ procedures and guide the process through the alignment of the documents to the overall RAF’s Strategy.

Qualifications and Experience

• Bachelor’s Degree/Advanced Diploma in Information Technology related qualification.
• Certified Cisco Network Professional (CCNP)
• Certified Cisco Security Professional (CCSP)
• Certified Operational framework like ITIL v4 process.
• Cisco Certified Internetwork Expert (CCIE) is an added advantage.
• Relevant 5-7 years+ experience in Networking and Security environment.
• Experience in Cisco firewall implementation and management.
• Experience in full implementation of secure corporate network.
• Experience in deployment of Cloud platform network services i.e. SDWAN is an added advantage.
• Extensive knowledge of network configuration, routing, switching, data communications and network tools
• Experience in identification of network related weaknesses or inefficiencies.
• Expertise to secure computer network by enforcing policies and defining monitoring methods and access.
• Experience in network capacity management and forecasting.

Technical and Behavioral Competencies Required

• 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.
• Conflict management
• Critical and innovative thinking
• Facilitation and Presentation Skills
• Policy conceptualisation and formulation
• Risk Management
• Programme/project management.
• Service Delivery Innovation
• Stakeholder development and relations
• Reporting
• Advanced knowledge in the design and implementation of network for new environments/offices.
• Ability to provide advanced technical support in network associated projects.
• Knowledge of AWS & Azure network environment including experience in deployment and configuration of core virtual network (VPC/Subnet/NACL/Security Groups) in cloud environments.
• Documentation skills
• Ability to communicate ideas in both technical and user-friendly language.
• Highly self-motivated and directed, with keen attention to detail.
• Able to successfully navigate within varying degrees of ambiguity in a fast-paced environment.
• Strong analytical and problem-solving abilities.

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”.

Manager: Medical Management

Division:  Claims

Reference No:  4858

Location:  

Centurion, Gauteng, ZA

Employment Type:  Permanent

Disability (EE targeted role):  Yes

T.A.S.K Grade:  16

Job Posting Salary:  R1,028,791.00

Job Posting End Date:  17 Sep 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: The Manager: Medical Management is accountable to manage the medical management capability in supporting the claims operations

Key Performance Areas

Policy Review and Implementation

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

Medical Management

• Manage medical assessments including injury assessments of past and future medical care, preauthorization and clinical coding.
• Manage the assessment of the seriousness of medical injuries and determination of future care.
• Manage the implementation of the tariff, 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.
• Review assessment  reports  and provide recommendations.

Exception handling

• Develop tracking methods to  report analysis results in business case scenarios.
• Manage the  development  and maintenance  of  formal  exception handling process within the medical management unit.
• Management of supporting policies and procedures in line with managing exception handling with the division •  Represent  the  Fund  in  relevant

Reporting

• Prepare and submit regulation reports as and when required to provide progress updates and/or inform management decisions.
• Develop reports/ policies/ procedures and guide the process through the alignment of the documents to the overall RAF’s Strategy.

Stakeholder management 

• Facilitate    and       manage communication with relevant internal and external stakeholders proactively   and   progressively manage the relationships.
• Communicate with all levels of stakeholder contact.
• Represent  the  Fund  in  relevant external activities and events.

People Management

• Facilitate  and manage communication with relevant internal and external stakeholders proactively   and   progressively manage the relationships.
• Communicate with all levels of stakeholder contact.
• Represent  the  Fund  in  relevant external activities and events.

Qualifications and Experience

• Bachelor’s Degree/Advanced Diploma in Health Sciences or Medical  related qualification.
• Postgraduate in a Health Sciences or Medical related qualification will be an added advantage.
• Registration with HPCSA/SANCA.
• Relevant 6-8 years’ experience in a Medical Management related environment of which 2 (two) years must have been on a management/supervisory level/area of expertise.

Technical and Behavioral Competencies Required

• Resilience
• Communication
• Working with People
• Network and Alliances
• Planning, Organising and Coordinating
• Employee Engagement
• Personal Mastery
• Ethics and Values
• Client Service Orientation
• Judgement and decision making
• 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
• Claims management process/ processes and systems.
• Medical Management
• Medical bill reviewing
• Medical case management
• Complex problem identification, solving and decision making
• Customer value proposition
• Good financial management skills
• Strong analytical capabilities
• Knowledge of Motor Vehicle Accident legislation
• PFMA knowledge
• Reporting

Occupational Therapist

Division:  Claims

Reference No:  4855

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:  17 Sep 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 Manager: Treatment and Protocols, the successful incumbent is accountable for the implementation of occupational therapy programs or undertaking of specified client care activities in line with the scope of practice for occupational therapist..

Key Performance Areas

Review. Align and Update Existing OT related Tariffs including In-Built Rules Applicable to OT Profession

• Review and identify gaps in the existing OT tariffs.
• Align the updated tariff to the developed evidence-based treatment protocols.
• Develop in-built rules and align them with the updated tariff.

Define and Develop Evidence Based Treatment Protocols in Respect of the Categories Injuries

• Define Treatment protocol framework comprising of clinical policies, processes and guidelines.
• Ensure that associated treatment protocols are identified for each case.
• Develop associated treatment plan templates which accommodates the following codes: ICD10 codes, CPT codes and NAPPI codes (cross walks).
• Organise for review of the protocols, guidelines and tariffs by relevant specialist in the field
• Ensure that treatment protocols are designed to assist patients to get back to their maximum potential in both work and sport, including adaptation to permanent disabilities.
• Develop processes for implementation for assessing clinical functions to:

• Conduct assessments to measure physical and functional abilities.
• Plan and directs specific therapeutic/rehabilitative programs.
• Select and designs a variety of activities that assist an affected movement or function.
• Assist patients to gain or regain skills in social, leisure and work environments through graded individual and group therapy and activity programs.
• Monitor the progress of patients and adjust treatment programme where required.

Draft Clinical Guidelines and Processes

• Draft concrete and specific guidelines to assist the medical/ rehabilitation staff on what type of care that should be provided.
• Visit work employees work places and homes to plan rehabilitation and re-intergration.
• Work as a member of a holistic rehabilitation team.
• Devise procedures and standards for treatment and exercise programs.
• Provide guidelines for need for appropriate orthopaedic assistive devices.
• Research, benchmark best practice for vocational rehabilitation.
• Draft guidelines for vocational rehabilitation and return to work.

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.

Stakeholder Management

• Consult with relevant stakeholders (Professional Bodies) on a regular basis to keep up with industry updates, eg. OTASA
• Ensure stakeholder awareness and buy-in on the new protocols being developed.
• Develop reports/ procedures and guide the process through the alignment of the documents to the overall RAF’s Strategy.
• Develop functional  reporting systems, for management, projects or performance reporting.
• Prepare proposals, briefings, presentations,  reports, and other documentation and provide management information both verbally and in report format.

Reporting

• Collect patient statistics to inform future decisions
• Compile monthly reports
• Develop & implement health education programs for claimants and relevant stakeholders
• Ensure processes are in place to have accurate and timeous patient data and information.

Qualifications and Experience

• Bachelor’s Degree/ Advanced Diploma in Occupational Therapy related qualification.
• Valid registration with the HPCSA as an Occupational Therapist.
• A qualification in evidence-based medicine and/or treatment protocol development will be advantageous.
• Relevant 5 – 7 years’ experience in the field of Occupational Therapy.
• Experience in Vocational Rehabilitation and Return to work guidelines.
• Experience in defining and developing evidence-based treatment protocols of Occupational Therapy-related treatment protocols
• With experience working with ICD 10 codes, CPT codes, NAPPI codes Experience in Functional Capacity Evaluation and associated reports and tariffs applicable.
• Experience in Vocational Rehabilitation, Community or Home-based Occupational Therapy, with a good understanding of issues of access, affordable and reasonable Home Modifications necessary for people living with disabilities.

Technical and Behavioral Competencies Required

• Resilience.
• Network and alliance.
• Employee engagement.
• Ethics and values.
• Change management.
• Critical and innovative thinking
• Policy conceptualisation and formulation.
• Risk Management.
• Stakeholder development and relations.
• Reporting.
• Computer literacy.
• Display a basic understanding of evidence-based medicine (rehabilitation)
• Knowledge of standards within the health industry
• Knowledge and understanding of systems and process requirements for efficient medical claims processing that are used in the medical aid or other funding industries
• Knowledge and understanding of rehabilitation principles
• Knowledge of the legislation governing RAF, policies and procedures
• Knowledge and understanding of the RABS Bill and its benefits
• Knowledge of Medical Disability Guidelines applicable to trauma and MVA related conditions.
• Knowledge of Medical Billing, Tariffs and Coding applicable to Occupational Therapy intervention and rehabilitation.
• Knowledge of modalities of treatment for musculo-skeletal, neurological and other conditions associated with trauma or motor vehicle accidents.
• Knowledge of the National Health Act, RAF Act, and other health related legislation such as the Medical Scheme’s Act, etc.
• Knowledge of general rules governing the tariffs for occupational therapy.
• Knowledge of modifiers applicable to Occupational Therapy tariffs
• Knowledge of evaluation procedures, measurements, assistive devices, treatment or rehabilitation procedures or therapy applicable to Occupational Therapy profession.

Manager: Tariff & Pharmaceuticals

Division:  Claims

Reference No:  4853

Location:  

Centurion, Gauteng, ZA

Employment Type:  Permanent

Disability (EE targeted role):  Yes

T.A.S.K Grade:  16

Job Posting Salary:  R1,028,791.00

Job Posting End Date:  17 Sep 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: Medical Advisory Management, the successful incumbent is accountable for managing the processes related to the management and update of the Medical Tariffs, formulary and related aspects as part of the clinical leadership and also providing accountability to the clinical research tea functions and medical advisory services. The role will coordinate across all areas aligned to medical claims processing to ensure overall service provider engagement.

Key Performance Areas

Develop and Update Medical Tariffs and Relate Pricing

• Serves as a medical expert and provide clinical leadership within the medical advisory team. 
• Analyse clinical research data.
• Provide clinical support to the clinical research team responses to all clinically related queries of RAF stakeholders e.g. attorneys, hospitals, etc.
• Check medical trends, experience and approaches and provide recommendations to the Senior Manager: Medical Advisory Management.
• Assist in the development of clinical work templates.
• Develop & implement health education programs for claimants and relevant stakeholders.

Develop Pharmaceutical Benefit Management (PBM) and Related Tools

• Update and manage tools for managing acute and chronic medication.
• Provide training and support to medical management in the use of PBM tools and  decision making aligned to regulated rates

Clinical Research, Expertise and Support within the Clinical Research Team

• Serves as a medical expert and provide clinical leadership within the medical advisory team.
• Analyse clinical and pharmaceutical research data.
• Provide clinical support to the clinical research team responses to all clinically related queries.
• Review medical trends, experience and approaches and provide recommendations to the Senior Manager.
• Assist in the development of clinical work templates.

Policy Review and Implementation

• Update and develop medical tariffs based on healthcare policies in line with clinical development.
• Provide training and support to medical management in the use of medical tariffs and decision making aligned to regulated rates.
• Assist in managing  decisions, actions, clinical information, communication and support related to claims processes, treatment and procedure.
• Develop and update medical tariffs for the RAF to assist in reduction of medical costs.

Stakeholder Management

• Liaise with key external and internal service providers on Medical Tariffs and drive adoption and adherence.
• Build collaborative working relationships with medical management for implementation purposes.
• Use clinical acumen to build and function in strong teams to ensure high performance.

Reporting

• Collection of patient statistics to inform future decisions.
• Compile monthly reports.
• Develop and implement health education programs for claimants and relevant stakeholders.

People Management

• Ensure the sourcing, development and retention of a high-performance team.
• 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

• Medical Degree (MBChB) or equivalent.
• Registration with the HPCSA as a Medical Doctor.
• Certificate in Evidence Based training (PTCMA) or Health Technology assessment (HTA) training or in progress of obtaining the qualification advantageous
• Postgraduate qualification will be advantageous.
• Relevant 6 – 8 years’ experience as a medical doctor in a managed care/ insurance/ healthcare environment, medical advisory work of which 2 years’ experience must have been on a management/ supervisory level/ area of expertise.
• Experience in the development and application of medical tariffs, pharmaceutical drug reviews policies, and working with a multi-disciplinary team of researchers to develop the medical tariffs.

Technical and Behavioral Competencies Required

• Resilience.
• Network and alliance.
• Employee engagement.
• Ethics and values.
• Change management.
• Critical and innovative thinking
• Policy conceptualisation and formulation.
• Risk Management.
• Stakeholder development and relations.
• Reporting.
• Ability to manage Medical Tariffs, pharmaceutical policies and guidelines in line with evidence- based medicine.
• Computer literacy on Microsoft package (Word, Power-point, Excel, Outlook, and Internet Explorer)
• Ability to draft treatment protocols, policies and guidelines in line with evidence-based medicine.
• Ability to work within framework and scope of clinical research team.
• Knowledge of new and evolving practices in medicine to allow for sound clinical expertise.
• Strong analytic skills and knowledge of health care industry with ability to provide solutions to meet client needs and maximize value of deliverables
• Knowledge and understanding of the marketplace and professional trade associations, key people and companies
• Understanding of Good Clinical Practice and analysis of research papers.
• Good understanding of clinical coding crosswalks and norms e.g. ICD10, CPT, Nappi codes, etc.
• Understanding of the National Health Policy Framework and new healthcare industry development.
• Knowledge and understanding of the fundamental processes of business, their interaction, and the impact of the external /internal influences on clinical decision-making, and deadline.

Consultant: Pre-Assessment

Division:  Claims

Reference No:  4817

Location:  

Johannesburg, Gauteng, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  13 Sep 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.

NB: This is a 12-Month Fixed-Term Contract position 

Purpose of the job: The Consultant: Pre-Assessment is responsible for the pre-assessment of prospective claims applications.

Key Performance Areas

Pre-Assessment of Prospective Claims

• Record all the submitted documents for prospective claims.
• Determine the benefits and the products submitted based on the submitted documents.
• Assess the submitted documents to determine compliance as per defined processes and rules.
• Apply compliance and/ lodgment rules in pre-accessing the prospective claim.
• Identify duplicate claims and linked claims.
• Examine the prescription of lodgment and apply prescription rules.
• Verify mortality with Home Affairs
•  Communicate the assessment outcomes to the prospective claimants.

Quality Assurance

• Ensure that pre-assessment processes are implemented and maintained at the highest standards.
• Maintain the implementation an unusual occurrence procedures.

Administrative Support

• Document the acknowledged claims.
• Deal with/and respond to correspondence.
• Produce documents, briefing papers,  reports, and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Stakeholder Management

• Maintain healthy relationships with all stakeholders.
• 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 a related qualification.

Experience

• Relevant 3 years’ experience in the claims environment.

Technical and behavioral competencies required

• Ability to differentiate different RAF Products
• Knowledge of Motor vehicle Act
• Complex problem identification, solving and decision making.
• Customer value proposition
• Good financial management skills
• Strong analytical capabilities
• Knowledge of Motor Vehicle Accident legislation
• PFMA knowledge
• Attention to detail.
• Planning, Organising and Coordinating
• Personal Mastery
• Judgement and Decision Making
• Ethics and Values
• Client Service Orientation

Consultant: Legal Costs x3

Division:  Claims

Reference No:  4825

Location:  

Johannesburg, Gauteng, 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:  13 Sep 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: The Consultant: Legal costs is responsible to consult with legal and medical experts to gain further insights into a claim and its resulting costs.

Key Performance Areas

Legal cost management

• Keep up-to-date wih all incoming claims.
• Read and interpret claims.
• Review claims to ensure no fradulant or contradictory claims are made.
• Determine if a claim requires the services of an attorney.
• Determine the actual fees due to an attorney for each case.
• Ensure all payments to attorney’s are fair and reasonable.
• Consult different service providers to understand where the organisation could save on legal fees..

Quality assurance

• Ensure that invoicing processes are implemented and maintained at the highest standards.
• Maintain the implementation of an unusual occurrence procedures

Administrative support

• Deal with/and respond to correspondence.
• Produce documents, briefing papers, reports and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• 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 a related qualification.

Experience

• Relevant 3 years’ experience in an insurance, legal or accounting related environment.

Competencies

• Behavioural
  • Planning, Organising and Coordinating
  • Personal Mastery
  • Judgement and  Decision Making
  • Ethics and Values
  • Client Service Orientation                                                                                                                                       
• Technical
  • Knowledge of legal costs.
  • Understanding of post claim management and settlement.
  • Medical bill reviewing.
  • Medical case management.
  • Complex problem identification, solving and decision making.
  • Customer value proposition.
  • Good financial management skills.
  • Strong Analytical capabilities.
  • Knowledge of Motor Vehicle Accident legislation.
  • PFMA knowledge.

Consultant: Offer Management x2

Division:  Claims

Reference No:  4830

Location:  

Johannesburg, Gauteng, 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:  13 Sep 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: The Consultant: Offer Management is responsible to quality assure, consult and  communicate the offer made and request payment on acepted offers.

Key Performance Areas

Offer Management

• Quality assure the type of offer made.
• Identify and correct any defects in consultation with the originator of the offer.
• Provide recommendations to the manager and team leader on settlement offers.
• Communicate approved offer.
• Request payment to be made.

Exeption Handling

• Assess the basis of the rejected offer.
• Make necessary adjustment on the initial offer and communicate.
• Suspend the claim until the dispute is resolved.

Quality assurance

• Ensure that legal costing processes are implemented and maintained at the highest standards.
• Maintain the implementation of an unusual occurrence procedures

Administrative support

• Document and upload offers on the system.
• Adequate provision of administrative support.
• Deal with/and respond to correspondence.
• Produce documents, briefing papers, reports and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos..

Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• 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 a Health Sciences or Law related qualification.

Experience

• Relevant 3 years’ experience in an insurance related environment.

Competencies

• Behavioural
  • Planning, Organising and Coordinating
  • Personal Mastery
  • Judgement and Decision Making
  • Ethics and Values
  • Client Service Orientation                                                                                                                                       
• Technical
  • Knowledge of cash flow and invoicing.
  • Understanding of post claim management and settlement.
  • Medical bill reviewing.
  • Medical case management.
  • Complex problem identification, solving and decision making.
  • Customer value proposition.
  • Good financial management skills.
  • Strong Analytical capabilities.
  • Knowledge of Motor Vehicle Accident legislation.
  • PFMA knowledge.
  • Knowledge of budgeting, sales, business development, and strategic planning.

Consultant: Invoicing x3

Division:  Claims

Reference No:  4829

Location:  

Johannesburg, Gauteng, 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:  13 Sep 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: The Consultant: Invoicing is responsible to create invoices for claimants as well ensure invoices are accurate, and resolve billing errors.

Key Performance Areas

Invoicing

• Keep client information details up-to-date.
• Create and send invoices and statements to clamaints.
• Check data input to ensure the accuracy of the final bill.
• Track payments and ensure that the cash flow into the company is profitable and does not result in losses for the organisation.
• Report issues or irregularities where necessary.
• Fix billing errors by issuing debit and credit memos.
• Initiating new procedures for billing where gaps are identififed.
• Recover any outstanding debts owed to the organisation as a resut of over or double payment.
• Provide payout progress.
• Categorise received Invoices by type.
• Validate the details of supplier claim or supplier invoice.
• Effective invoicing.
• Validate the expert invoice and expert details.
• Conduct duplicate checks on all invoices before issueing.

Quality assurance

• Ensure that invoicing processes are implemented and maintained at the highest standards.
• Maintain the implementation of an unusual occurrence procedures

Administrative support

• Deal with/and respond to correspondence.
• Produce documents, briefing papers,  reports and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

 Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• 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 a Finance related qualification.

Experience

• Relevant 3 years’ experience in a invoicing or accounting related environment.

Competencies

• Behavioural
  • Planning, Organising and Coordinating
  • Personal Mastery
  • Judgement and Decision Making
  • Ethics and Values
  • Client Service Orientation                                                                                                                                       
• Technical
  • Knowledge of cash flow and invoicing.
  • Understanding of post claim management and settlement.
  • Medical bill reviewing.
  • Medical case management.
  • Complex problem identification, solving and decision making.
  • Customer value proposition.
  • Good financial management skills.
  • Strong Analytical capabilities.
  • Knowledge of Motor Vehicle Accident legislation.
  • PFMA knowledge.

Officer: Legal Administration (x4)

Division:  Governance

Reference No:  4834

Location:  

Johannesburg, Gauteng, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  13 Sep 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.

NB: This is a 12-Month Fixed-Term Contract position 

Purpose of the job: The Officer: Legal Administration is accountable to process documentation relating to claims settlement as well as the effective coordination of processes and procedures that contribute to the efficient early settlement of claims dispute/s outside court proceedings.

Key Performance Areas

Legal Administration

• Transcribe and proof-read legal documents for settlement discussions.
• Collate all the directives and update on the case file database.
• Retrieval of information at all times as requested in the office.
• Administer process relating to the arbitration of disputes between parties.
• Briefing experts for purposes of administering the claims.
• Administer hearings sessions to ensure that all parties and present information or evidence relative to claims is obtained.
• Ensure confidentiality of all documents under control and that documentation reaches the intended recipients.
• Follow-up on outstanding matters on behalf of the Legal Administration department in the office.
• Document the proceedings and follow up on the action log relation to the settlement of the claim’s discussion.
• File all settlement agreements.

Block Settlements

• Arrange meetings for block settlements.
• Management of court documentation and filing.
• Diarise and monitor court processes.
• Narrate and provide clarity on the assessment and determination on the claims offer done

Reporting

• Contribute to the preparation and submission of reports.
• Report regularly and periodically perform necessary submissions as and when required to provide progress updates and/or inform management decisions.

Stakeholder Management

• Aid in proactive and progressive relationships with key stakeholders.
• Deal with inquiries and requests for information from both internal and external stakeholders.

Qualifications

• Bachelor’s degree in law or equivalent.

Experience

• Relevant 3 years’ experience in a Legal Administration related environment.

Technical and behavioral competencies required

• Dispute resolution, mediation and negotiating capabilities.
• Legislation & Regulatory Knowledge including Personal Injury and Third-party compensation.
• Knowledge of laws and legislation that are applicable to the organisation.
• Knowledge of Civil proceedings in the Magistrate, Regional and High Courts of South Africa
• Planning, Organising and Coordinating.
• Personal Mastery.
• Judgement and  Decision Making.
• Ethics and Values.
• Client Service Orientation.

Consultant: Verification and Validation (x2)

Division:  Claims

Reference No:  4819

Location:  

Johannesburg, Gauteng, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  13 Sep 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.

NB: This is a 12-Month Fixed-Term Contract position 

Purpose of the job: The Consultant: Verification and Validation is responsible for the verification and validation of registered claims.

Key Performance Areas

Verification and Validation.

• Apply sound legal RAF Act and Regulations to Act, Case Law) knowledge on daily basis to validate claims.
• Search for and apply relevant Case Law during verification and validation.
• Determine the need to call in the injured for questioning in line with the RAF act.
• Apply RAF procedures to validate the claims.
• Assess duplicate claims to address mandates and minimise further processing of duplicate claims.
• Examine and apply the prescription of rules at the claim and product level.
• Verify data and information with relevant stakeholders.
• Assess the validity of death benefits products to determine locus standi.

Quality Assurance

• Maintain and update necessary  reporting standards as per standard operating procedure.
• Adequate and sound quality assurance.
• Ensure that verification and validation are maintained at the highest standards.
• Maintain the implementation of an unusual occurrence procedure.

Administrative Support

• Document the acknowledge pre assessed claims.
• Deal with/and respond to correspondence.
• Produce documents, briefing papers, reports, and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Stakeholder Management

• Maintain healthy relationships with all stakeholders.
• 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.

Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Qualifications

• Bachelor’s Degree/ Advanced Diploma in a related qualification.

Experience

• Relevant 3 years’ experience in the claims enviroment.

Technical and behavioral competencies required

• Ability to differentiate different RAF Products
• Knowledge of Motor vehicle Act
• Complex problem identification, solving and decision making.
• Customer value proposition
• Good financial management skills
• Strong analytical capabilities
• Knowledge of Motor Vehicle Accident legislation
• PFMA knowledge
• Attention to detail.
• Planning, Organising and Coordinating
• Personal Mastery
• Judgement and Decision Making
• Ethics and Values
• Client Service Orientation

Consultant: LOS Adjudication

Division:  Claims

Reference No:  4823

Location:  

Johannesburg, Gauteng, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  Yes

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  6 Sep 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: The Consultant: Loss Of Support Adjudication is responsible for the processing of claimant applications with regards to loss of support adjudication.

Key Performance Areas 

Loss of support adjudication

• Review the claim against the loss of support adjudication standards.
• Assess loss of support supporting documents and data to determine the deseased duty to support (confirming affirnity).
• Determine deceased ability to support the dependants by assesing income supporting data/documents in line with the approved quantum.
• Apply applicable case laws and Statutory limit to determine the LOE quantum.
• Based on the findings make a determination to reject or approve.
• Assess actuarial  reports and make a determination to whether to instruct internal actuarial team to make actuarial calculation or not.

Quality assurance

• Research, analyse, and review policies and laws relevant to assigned cases
• Participate in the consultations process on the implementation of claims and related processes.
• Ensure that LOS Adjudication and processes are implemented and maintained at the highest standards.
• Maintain the implementation an unusual occurrence procedures.

Administrative support

• Deal with/and respond to correspondence.
• Produce documents, briefing papers, reports and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos

Reporting

• Track and report against set objectives and targets
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• Follow up and resolve all queries, following 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 a related qualification to discipline
• Relevant 3 years’ experience in a claims adjudication related environment.

Technical and Behavioural Competencies Required

• Planning, organisation and coordinating
• Personal mastery.
• Judgement and  Decision Making
• Ethics and values.
• Client service orientation
• Claims management process/ processes and systems.
• Complex problem identification, solving and decision making
• Customer value proposition
• Good financial management skills
• Strong analytical capabilities
• Knowledge of Motor Vehicle Accident legislation
• Interpersonal relations
• PFMA knowledge.

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”.

Consultant: LOE Adjudication

Division:  Claims

Reference No:  4822

Location:  

Johannesburg, Gauteng, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  Yes

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  13 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Consultant: LOE Adjudication is responsible for the processing of claimant applications with regards to loss of earnings.

Key Performance Areas

Loss of earning adjudication

• Confirm and record medical management recommendations.
• Review the claim against the loss of earnings adjudication standards.
• Check injury documents substantiating an ability to earn an income and make a determination.
• Analyze the age, qualification level and skillset of the claimant to determine whether the applicant qualifies for an LOE.
• Make a determination on whether the injured is able to earn an income or not as well as whether the injured is major or minor.
• Apply applicable case laws and Statutory limit to determine the LOE quantum.
• Schedule the injured for medical assessment in line with the findings.
• Make recommendations on an appropriate amount of money for payout per case.

Quality assurance

• Adjudicate the LOE product claim in line with the approved policy/SOP.
• Participate in the consultations process on the implementation of programs and services.
• Ensure that programs and services are implemented and maintained to the highest standards.
• Implement the development and implementation of an unusual occurrence procedures.
• Quality assure the loss of earning claims before they can be progressed to the next phase of the claims processing.

Administrative support

• Record and document proof of affinity.
• Deal with/and respond to correspondence.
• Produce documents, briefing papers,  reports, and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Reporting 

• Track and report against set objectives and targets. 
• Report on emerging risks. 
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• Follow up and resolve all queries, following 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

• Bachelor’s Degree/Advanced Diploma in a related qualification

Experience

• Relevant 3 years’ experience in a claims adjudication related environment

Technical and behavioral competencies required

• Claims management process/ processes and systems
• Complex problem identification, solving and  decision making
• Customer value proposition
• Good financial management skills
• Strong analytical capabilities
• Knowledge of Motor Vehicle Accident legislation
• PFMA knowledge
• 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.”

Consultant: Pre-Assessment

Division:  Claims

Reference No:  4777

Location:  

East London, Eastern Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  12 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Consultant: Pre-Assessment is responsible for the pre-assessment of prospective claims applications.

Key Performance Areas

Pre-Assessment of prospective claims

• Record all the submitted documents for prospective claims.
• Determine the benefits and the products submitted based on the submitted documents.
• Assess the submitted documents to determine compliance as per defined processes and rules.
• Apply compliance and/ lodgment rules in pre-accessing the prospective claim.
• Identify duplicate claims and linked claims.
• Examine the prescription of lodgment and apply prescription rules.
• Verify mortality with Home Affairs
• Communicate the assessment outcomes to the prospective claimants.

Quality assurance

• Ensure that pre-assessment processes are implemented and maintained at the highest standards.
• Maintain the implementation an unusual occurrence procedures.

Administrative support

• Document the acknowledged claims.
• Deal with/and respond to correspondence.
• Produce documents, briefing papers, reports, and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• 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 a related qualification.

Experience

• Relevant 3 years’ experience in the Claims environment.

Technical and behavioral competencies required

• Ability to differentiate different RAF Products
• Knowledge of Motor vehicle Act
• Complex problem identification, solving and decision making.
• Customer value proposition
• Good financial management skills
• Strong analytical capabilities
• Knowledge of Motor Vehicle Accident legislation
• PFMA knowledge
• Attention to detail.
• 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.”

Consultant: Loss of Support Adjudication

Division:  Claims

Reference No:  4742

Location:  

East London, Eastern Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  10 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Consultant: Loss of Support Adjudication is responsible for the processing of claimant applications with regards to loss of support adjudication.

Key Performance Areas

Loss of support adjudication

• Review the claim against the loss of support adjudication standards.
• Assess loss of support supporting documents and data to determine the deceased duty to support (confirming affinity).
• Determine deceased ability to support the defendants by assessing income supporting data/documents in line with the approved quantum.
• Apply applicable case laws and Statutory limit to determine the LOE quantum.
• Based on the findings, make a determination to reject or approve. 
• Assess actuarial  reports and make a determination to whether to instruct internal actuarial team to make actuarial calculation or not.
• Make an offer and submit to offer management for further communication with the claimant.

Quality assurance

• Research, analyse, and review policies and laws relevant to assigned cases.
• Participate in the consultations process on the implementation of claims and related processes.
• Ensure that LOS Adjudication and processes are implemented and maintained at the highest standards.
• Maintain the implementation an unusual occurrence procedures.

Administrative support

• Deal with/and respond to correspondence.
• Produce documents, briefing papers, reports, and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Reports

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• Follow up and resolve all queries, following 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

• Bachelor’s Degree/Advanced Diploma in a related qualification to discipline.

Experience

• Relevant 3 years’ experience in a claims adjudication related environment.

Technical and behavioral competencies required

• Claims management process/ processes and systems.
• Complex problem identification, solving and decision making.
• Customer value proposition 
• Good financial management skills
• Strong analytical capabilities
• Knowledge of Motor Vehicle Accident legislation
• PFMA knowledge
• 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.”

Consultant: Legal Costs (X2)

Division:  Claims

Reference No:  4753

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:  10 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Consultant: Legal costs is responsible to consult with legal and medical experts to gain further insights into a claim and its resulting costs.

Key Performance Areas

Legal cost management

• Keep up to date with all incoming claims.
• Read and interpret claims.
• Review claims to ensure no fraudulent or contradictory claims are made.
• Determine if a claim requires the services of an attorney.
• Determine the actual fees due to an attorney for each case.
• Ensure all payments to attorneys are fair and reasonable.
• Consult different service providers to understand where the organisation could save on legal fees.

Quality assurance

• Ensure that legal costing processes are implemented and maintained at the highest standards.
• Maintain the implementation of an unusual occurrence procedures.

Administrative support

• Deal with/and respond to correspondence.
• Produce documents, briefing papers,  reports, and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

 Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• 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 a related qualification.

Experience

• Relevant 3 years’ experience in an insurance, legal or accounting related environment.

Technical and behavioral competencies required

• Knowledge of legal costs.
• Understanding of post claim management and settlement.
• Medical bill reviewing.
• Medical case management.
• Complex problem identification, solving and decision making.
• Customer value proposition.
• Good financial management skills.
• Strong Analytical capabilities.
• Knowledge of Motor Vehicle Accident legislation.
• PFMA knowledge.
• 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.”

Consultant: Future Medical Adjudication

Division:  Claims

Reference No:  4744

Location:  

East London, Eastern Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  10 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Consultant: Future Medical Adjudication is responsible for the verification of eligibility for claims to be paid out based on future medical findings.

Key Performance Areas

Future medical adjudication

•     Check and activate pre-defined injury specific undertaking from accident information Centre.

•     Confirm and record medical management recommendations.

•     Develop and issue injury specific undertaking to the qualifying claimant and apply court outcomes

      where required.

•     Quantify the cost of the developed injury specific undertaking.

•     Check developed treatment / rehab plan / injured needs and develop specified undertaking/offer

      certificate.

•     Approve offer in line with the DOA.

•     After approval, communicate FME certificate to the claimant through offer management department.

Quality assurance

•     Participate in the consultations process on the implementation of claims and related processes.

•     Ensure that claims and processes are implemented and maintained at the highest standards.

•     Maintain the implementation of unusual occurrence procedures.

•     Ensure the accurate quantification of future medical expenses.

Administrative support

•     Deal with/and respond to correspondence.

•     Produce documents, briefing papers, reports, and presentations.

•     Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Reporting

•     Track and report against set objectives and targets.

•     Report on emerging risks.

•     Provide ad hoc reports on process improvement initiatives.

Stakeholder management

•     Maintain healthy relationships with all stakeholders.

•     Follow up and resolve all queries, following 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

•     Bachelor’s Degree/ Advanced Diploma in a Health Sciences related qualification to discipline.

•     Registration with SANCA

Experience

•     Relevant 3 years’ experience in a claims adjudication related environment.

Technical and behavioral competencies required

•     Knowledge of tariffs: National Health Reference Price List (NHRPL) and Uniform Patient Fee

      Schedule (UPFS).

•     Knowledge of procedure and treatment codes: ICD 10 and CPT4.

•     Basic understanding of managed health care industry in South Africa. (Medical claims and charges).

•     Claims assessment and settlement process and systems (including handling, general damages

      assessment and settlement)

•     Claims management process/ processes and systems (including handling, verification and validation,

      investigation, assessment/settlement, litigation, legal costs assessment and settlement)

•     Medical case management

•     Complex problem identification, solving and  decision making.

•     Claims management processes and systems

•     Customer value proposition

•     Good financial management skills

•     Strong analytical capabilities

•     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.”

Consultant: Invoicing

Division:  Claims

Reference No:  4747

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:  10 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Consultant: Invoicing is responsible to create invoices for claimants as well as ensuring invoices are accurate and resolve billing errors.

Key Performance Areas

Invoicing

• Keep client information details up-to date.
• Create and send invoices and statements to claimants.
• Check data input to ensure the accuracy of the final bill.
• Track payments and ensure that the cash flow into the company is profitable and does not result in losses for the organisation.
• Report issues or irregularities where necessary.
• Fix billing errors by issuing debit and credit memos.
• Initiating new procedures for billing where gaps are identified.
• Recover any outstanding debts owed to the organisation as a result of over or double payment.
• Provide payout progress.
• Categorize received Invoices by type.
• Validate the details of supplier claim or supplier invoice
• Validate the expert invoice and expert details.
• Conduct duplicate checks on all invoices before issuing.

Quality assurance

• Ensure that invoicing processes are implemented and maintained at the highest standards.
• Maintain the implementation of an unusual occurrence procedures.

Administrative support

• Deal with/and respond to correspondence.
• Produce documents, briefing papers, reports, and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• 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 a Finance related qualification.

Experience

• Relevant 3 years’ experience in an invoicing or accounting related environment.

Technical and behavioral competencies required

• Understanding of post claim management and settlement.
• Medical bill reviewing.
• Medical case management.
• Complex problem identification, solving and decision making.
• Customer value proposition.
• Good financial management skills.
• Strong Analytical capabilities.
• Knowledge of Motor Vehicle Accident legislation.
• PFMA knowledge.
• Knowledge of budgeting, sales, business development, and strategic planning.
• 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.”

Consultant: Merits (X3)

Division:  Claims

Reference No:  4752

Location:  

East London, Eastern Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  10 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Consultant: Merits is responsible for the assessment of merits to determine RAF liability as well as obtain information from various stakeholders in order to assess the merits for claims.

Key Performance Areas

Merits management

• Compare the data on the accident information Centre against the claim to determine RAF liability.
• Categorize merits assessment using RAF defined merits classification (driver/non driver).
• Thoroughly investigate the merits of a claim/assessment of the merits file.
• Apply merits scenarios and rules to determine merits outcomes.
• Complete all necessary checklists and apply application categorization rules.
• Determine the need for a referral to claims investigation unit for further investigation and analyze the
• outcomes.
• Record merits outcome and generate the offer.
• Submit the offer-to-offer management for further  communication to the claimant.

Quality assurance

• Quality assures the outcomes liability determination and captures the reasons for disagreement.
• Ensure that merits processes are implemented and maintained at the highest standards.
• Maintain the implementation of an unusual occurrence procedure.

Administrative support

• Verify registered merits information against Accident data Centre.
• Deal with/and respond to correspondence.
• Produce documents, briefing papers,  reports, and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• Follow up and resolve all queries, following 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.

Qualifications

• Bachelor’s Degree/ Advanced Diploma in a Health Sciences or Law related qualification.

Experience

• Relevant 3 years’ experience in an insurance/ investigations/ claims related environment.

Technical and behavioral competencies required

• Understanding of post claim management and settlement.

• Medical bill reviewing.
• Medical case management.
• Complex problem identification, solving and decision making.
• Customer value proposition.
• Good financial management skills.
• Strong Analytical capabilities.
• Knowledge of Motor Vehicle Accident legislation.
• PFMA knowledge.
• Knowledge of budgeting, sales, business development, and strategic planning.
• Planning, Organizing 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.”

Consultant: Past Medical Adjudication

Division:  Claims

Reference No:  4743

Location:  

East London, Eastern Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  10 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Consultant: Past Medical Adjudication is responsible for the verification of eligibility for claims to be paid out based on past medical outcomes.

Key Performance Areas

Past medical adjudication

• Receive and record medical management bill review assessment outcome.
• Perform duplicate, mortality and prescriptions checks.
• Receive invoices and check payment requests for accuracy and correctness.
• Load payment request.
• Make an offer on available voucher and apply contingencies where applicable.
• Check substantial compliance with RAF Act.

Quality assurance

• Participate in the consultations process on the implementation of claims and related processes.
• Ensure that claims and processes are implemented and maintained at the highest standards.
• Maintain the implementation an unusual occurrence procedure.

Administrative support

• Deal with/and respond to correspondence.
• Produce documents, briefing papers, reports, and presentations.
• Taking dictation and minutes, letters to various parties, and memos.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.
• Screen phone calls, inquiries, and requests.

 Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• Follow up and resolve all queries, following 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

• Bachelor’s Degree/Advanced Diploma in a related qualification.

Experience

• Relevant 3 years’ experience in a claims adjudication related environment.

Technical and behavioral competencies required

• Knowledge of tariffs: National Health Reference Price List (NHRPL) and Uniform Patient Fee Schedule (UPFS).
• Knowledge of procedure and treatment codes: ICD 10 and CPT4.
• Basic understanding of managed health care industry in South Africa. (Medical claims and charges).
• Claims assessment and settlement process and systems (including handling, general damages assessment and settlement)
• Medical case management
• Complex problem identification, solving and  decision making.
• Claims management processes and systems
• Customer value proposition
• Good financial management skills
• Strong analytical capabilities
• Knowledge of Motor Vehicle Accident legislation
• PFMA knowledge
• 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.”

Consultant: Loss of Earnings Adjudication (X2)

Division:  Claims

Reference No:  4750

Location:  

East London, Eastern Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  10 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Consultant: LOE Adjudication is responsible for the processing of claimant applications with regards to loss of earnings.

Key Performance Areas

Loss of earning adjudication

• Confirm and record medical management recommendations.
• Review the claim against the loss of earnings adjudication standards.
• Check injury documents substantiating an ability to earn an income and make a determination.
• Analyze the age, qualification level and skillset of the claimant to determine whether the applicant qualifies for an LOE.
• Make a determination on whether the injured is able to earn an income or not as well as whether the injured is major or minor.
• Apply applicable case laws and Statutory limit to determine the LOE quantum.
• Schedule the injured for medical assessment in line with the findings.
• Make recommendations on an appropriate amount of money for payout per case.

Quality assurance

• Adjudicate the LOE product claim in line with the approved policy/SOP.
• Participate in the consultations process on the implementation of programs and services.
• Ensure that programs and services are implemented and maintained to the highest standards.
• Implement the development and implementation of an unusual occurrence procedures.
• Quality assure the loss of earning claims before they can be progressed to the next phase of the claims processing.

Administrative support

• Record and document proof of affinity.
• Deal with/and respond to correspondence.
• Produce documents, briefing papers,  reports, and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Reporting 

• Track and report against set objectives and targets. 
• Report on emerging risks. 
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• Follow up and resolve all queries, following 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

• Bachelor’s Degree/Advanced Diploma in a related qualification

Experience

• Relevant 3 years’ experience in a claims adjudication related environment

Technical and behavioral competencies required

• Claims management process/ processes and systems
• Complex problem identification, solving and  decision making
• Customer value proposition
• Good financial management skills
• Strong analytical capabilities
• Knowledge of Motor Vehicle Accident legislation
• PFMA knowledge
• 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.”

Consultant: Offer Management

Division:  Claims

Reference No:  4746

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:  10 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Consultant: Offer Management is responsible to quality assure, consult, and communicate the offer made and request payment on accepted offers.

Key Performance Areas

Offer Management

• Quality assure the type of offer made.
• Identify and correct any defects in consultation with the originator of the offer.
• Provide recommendations to the manager and team leader on settlement offers.
• Communicate approved offer.
• Request payment to be made.

Exception Handling

• Assess the basis of the rejected offer.

• Make necessary adjustment on the initial offer and communicate.
• Suspend the claim until the dispute is resolved.

Quality assurance

• Ensure that legal costing processes are implemented and maintained at the highest standards.
• Maintain the implementation an unusual occurrence procedures.

Administrative support

• Document and upload offers on the system.

• Deal with/and respond to correspondence.
• Produce documents, briefing papers, reports, and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• 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 a Health Sciences or Law related qualification.

Experience

• Relevant 3 years’ experience in an insurance related environment.

Technical and behavioral competencies required

• Understanding of post claim management and settlement.
• Medical bill reviewing.
• Medical case management.
• Complex problem identification, solving and decision making.
• Customer value proposition.
• Good financial management skills.
• Strong Analytical capabilities.
• Knowledge of Motor Vehicle Accident legislation.
• PFMA knowledge.
• Knowledge of budgeting, sales, business development, and strategic planning.
• 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.”

RAF Attorney: High Court x2

Division:  Governance

Reference No:  4766

Location:  

Cape Town, Western Cape, ZA

Employment Type:  Permanent

Disability (EE targeted role):  No

T.A.S.K Grade:  16

Job Posting Salary:  R1,028,791.00

Job Posting End Date:  17 Sep 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: The RAF Attorney: High Court is responsible for all High Court matters within the Fund and to offer litigation services accordingly. This role will also be responsible to perform a range of tax services including tax bill of costs in compliance with South African laws and regulations.

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.

Preparation and Research on Related Litigation Matters

• Conduct research that will provide information in preparation for all matters for trial.
• Consult with client departments/ representatives, and witnesses for instructions and documentation for cases to be presented in Court.
• Draft pleadings to provide clear motivation/justification on a particular position about the case.

Mediation Process

• All required steps regarding the mediation process, as governed by the amendment to the rules of court, are to be taken.
• Upon conclusion of the mediation, parties shall inform Registrar and all other parties by a notice that Mediation is completed.
• Parties & Mediator must within 5 days of completion of mediation issue a joint minute indicating.

Represent the Road Accident Fund on all third party claims related litigation matters

• Attend court appearances in all allocated third-party litigation matters.
• Ensure file administration from opening to the conclusion of a legal case including adherence to trial dates.
• Handle appearances at courts, tribunals, mediation hearings and inquiries.
• Coordinate administrative legal actions to ensure compliance.
• Approve instructions to appoint and instruct expert witnesses.

Settle non-litigious matters before they are set down for trial

• Block consultation, early assessment of files, and early instructions to experts and assessors.
• Approve requests to appoint and instruct assessors and expert witnesses. 
• Recommend a settlement.

Provision of legal advice to RAF

• Provide legal advice on arising legal matters and contracts.
• Provide well-researched legal advice on matters impacting the organisation.
• Conduct legal research and prepare legal opinions.

Taxation

• Deliver a full range of tax services in compliance with laws and regulations.
• Build relationships and interact with clients to provide consulting and expertise in tax services.
• Provide innovative tax planning and review complex income tax returns

 Reporting

• Prepare and submit regulation reports as and when required to provide progress updates and/or inform management decisions.
• Develop reports/ policies/ procedures and guide the process through the alignment of the documents to the overall RAF’s Strategy.
• Develop functional  reporting systems, for management, projects or performance reporting.
• Prepare proposals, briefings, presentations, reports, and other documentation and provide management information both verbally and in report format.

Stakeholder Management

• Facilitate and manage communication with relevant internal and external stakeholders in relation to investments and proactively 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.

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

• Bachelor’s Degree in Law or equivalent.
• Postgraduate in Law or equivalent.
• Admission as an Attorney of the High Court or Advocate.
• Right of appearance in the High Court.

Experience

• Relevant 5-7 years legal experience post-graduation or admission of which 2 years must have been on area of expertise (personal injury litigation).

Behavioural

• • 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

Managerial

• • 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

Technical

• • Legislation & regulatory knowledge
  • Ethics & compliance
  • Monitoring and evaluation
  • Policy and standards
  • Governance
  • Claims litigation
  • MVA law and legislation
  • Negotiation
  • Conflict resolution
  • Problem solving and analysis
  • Mediation

Road Accident Fund Values

• Integrity
• Compassion
• Accountability
• Respect
• Excellence
• Empathy

Consultant: Verification and Validation (x2)

Division:  Claims

Reference No:  4738

Location:  

East London, Eastern Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  10 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Consultant: Verification and Validation is responsible for the verification and validation of registered Claims.

Key Performance Areas

Verification and Validation.

• Apply sound legal RAF Act and Regulations to Act, Case Law) knowledge on daily basis to validate claims.
• Search for and apply relevant Case Law during verification and validation.
• Determine the need to call in the injured for questioning in line with the RAF act.
• Apply RAF procedures to validate the claims.
• Assess duplicate claims to address mandates and minimise further processing of duplicate claims.
• Examine and apply the prescription of rules at the claim and product level.
• Verify data and information with relevant stakeholders.
• Assess the validity of death benefits products to determine locus standi.

Quality assurance

• Maintain and update necessary  reporting standards as per standard operating procedure.
• Adequate and sound quality assurance.
• Ensure that verification and validation are maintained at the highest standards.
• Maintain the implementation of an unusual occurrence procedure.

Administrative support

• Document the acknowledge pre assessed claims.
• Deal with/and respond to correspondence.
• Produce documents, briefing papers,  reports, and presentations.
• Assist with typing and editing briefs, technical papers, letters to various parties, and memos.

Stakeholder management

• Maintain healthy relationships with all stakeholders.
• 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.

Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.

Qualifications

• Bachelor’s Degree/Advanced Diploma in a related qualification.

Experience

• Relevant 3 years’ experience in the Claims environment.

Technical and behavioral competencies required.

• Ability to differentiate different RAF Products
• Knowledge of Motor vehicle Act
• Complex problem identification, solving and decision making.
• Customer value proposition
• Good financial management skills
• Strong analytical capabilities
• Knowledge of Motor Vehicle Accident legislation
• PFMA knowledge
• Attention to detail.
• 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.

Officer: Legal Administration (x2)

Division:  Governance

Reference No:  4759

Location:  

East London, Eastern Cape, ZA

Employment Type:  Fixed Term Contract

Disability (EE targeted role):  No

T.A.S.K Grade:  10

Job Posting Salary:  R434,656.00

Job Posting End Date:  10 Sep 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.

Note: This is a 12-month, fixed-term contract position

Purpose of the job: The Officer: Legal Administration is accountable to process documentation relating to claims settlement as well as the effective coordination of processes and procedures that

contribute to the efficient early settlement of claims dispute/s outside court proceedings.

Key Performance Areas

Legal Administration.

• Transcribe and proofread legal documents for settlement discussions.
• Collate all the directives and update on the case file database.
• Retrieval of information at all times as requested in the office.
• Administer process relating to the arbitration of disputes between parties.
• Briefing experts for purposes of administering the claims.
• Administer hearings sessions to ensure that all parties and present information or evidence relative to claims is obtained.
• Ensure confidentiality of all documents under control and that documentation reaches the intended recipients.
• Follow-up on outstanding matters on behalf of the Legal Administration department in the office.
• Document the proceedings and follow up on the action log relation to the settlement of the claim’s discussion.
• File all settlement agreements.

Block Settlements.

• Arrange meetings for block settlements.
• Management of court documentation and filing.
• Diarise and monitor court processes.
• Narrate and provide clarity on the assessment and determination on the claims offer done

 Reporting

• Contribute to the preparation and submission of reports.
• Report regularly and periodically perform necessary submissions as and when required to provide progress updates and/or inform management decisions.

Stakeholder management

• Aid in proactive and progressive relationships with key stakeholders.
• Deal with inquiries and requests for information from both internal and external stakeholders.

Qualifications

• Bachelor’s degree in law or equivalent.

Experience

• Relevant 3 years’ experience in a Legal Administration related environment.

Technical and behavioral competencies required

• Dispute resolution, mediation and negotiating capabilities.
• Legislation & Regulatory Knowledge including Personal Injury and Third-party compensation.
• Knowledge of laws and legislation that are applicable to the organisation.
• Knowledge of Civil proceedings in the Magistrate, Regional and High Courts of South Africa
• 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.”

Click here to apply

All the best with your applications.