The Road Accident Fund (RAF) invites suitably qualified applicants to apply for the Consultant: Medical Management vacancies (x24 posts). These are 36-month fixed-term contract positions based in East London, Eastern Cape.
Closing Date: 25 September 2025
Location: East London, Eastern Cape, South Africa
Salary: R501,775.00 per annum
Purpose of the Job
The Consultant: Medical Management will be responsible for implementing medical management activities, handling medical exceptions, and providing administrative support in the claims process.
Key Performance Areas
Medical Management
- Conduct medical assessments and compile injury assessment reports.
- Review bills and claims to ensure appropriate care levels, length of stay, and treatment quality.
- Apply RAF tariffs, treatment protocols, and cost-saving initiatives.
- Preauthorize submitted claims in line with RAF clinical guidelines.
- Escalate complex cases for multi-disciplinary review.
Exception Handling
- Implement and maintain a formal exception handling process.
- Document and update exception handling procedures.
- Ensure unusual occurrences are recorded and managed.
Reporting
- Track and report progress against set targets.
- Identify and report emerging risks.
- Provide process improvement reports and presentations.
Stakeholder Management
- Maintain healthy stakeholder relationships.
- Resolve queries and provide feedback within turnaround times.
- Make recommendations on corrective actions.
Minimum Qualifications
- Bachelor’s Degree/Advanced Diploma in Health Sciences or a related medical qualification.
- Registration with HPCSA/SANCA.
Experience Required
- At least 3 years’ relevant experience in a medical-related environment.
Competencies
- Claims management processes and systems.
- Medical case and product management.
- Medical bill reviewing.
- Strong clinical analytical skills.
- Knowledge of motor vehicle accident legislation.
- Excellent communication, decision-making, and client service orientation.
How to Apply
Interested applicants must submit their applications online at the RAF careers portal.
Click here to apply for the RAF Consultant: Medical Management Vacancies 2025