The Road Accident Fund is a state insurer established by statute, it provides insurance cover to all drivers of motor vehicles in South Africa in respect of liability incurred or damage caused as a result of a traffic collision. Liability incurred in relation to property damage (such as damage to vehicles, buildings, vehicle contents) is excluded from cover.
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Key Performance Areas
Legal Secretarial Administration
- Prepare court statements and forms that Attorneys will need in court.
- Dictate Attorney’s audio files and written notes.
- Transcribe and proofread legal documents.
- Index and update pleadings and discovery binders.
- Collect and deliver documents.
- Supporting legal research for cases and communicating with vendors, experts, attorneys, opposing counsel and other staff
Standard, process and procedure maintenance
- Ensure a strategy framework is maintained by required standards
- Keep abreast of internal standards and business goals to ensure adherence to sound internal control.
- Provide administrative support to the strategy and reporting office by RAF policies and procedures.
Quality Assurance Activities
- Maintain up-to-date written documentation and policies related to the organization's business activities.
Office Management
- Maintain correspondence, filing, telephonic queries and provide general administration support to the office.
- Maintain strict confidentiality in all matters relating to the office.
- Make follow-ups on outstanding matters on behalf of the Legal Services department in the office.
- Ensure all office requests are handled and responded to within set timelines.
- Ensure availability of stationery within the department.
Meeting and diary management
- Arrange meetings on behalf of the Legal Services Department.
- Take minutes and distribute these in accordance to set governance standards.
- Mantain 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.
Document Control
- Ensure that the filing system is always up-to-date and functional.
- Collate court rolls received from the Registrar for the responsible court divisions, update references and distribute to state attorneys
- 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.
- Collate all the court directives and update on the court directives database
- Maintain status update and records of all high value foreign national records for re-insurance purposes and report regularly
Qualifications
- National Diploma in Business Administration/Law related qualification.
Experience
- Relevant 2 years' experience in a business/law administration related environment.
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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.
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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.
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Key Performance Areas
Management of Department
- Development the business plans for the CEC aligned with the RAF strategic plan of the RAF.
- Provide technical assistance to employees within the Claims Onboarding Department in the Province.
- Claims Onboarding include consultations, origination of direct claims, direct claim lodgement, pro-active and re-active information collection, and pre-merits assessment.
- Manage the activities of the Hospital Service Centres, Community service Centre (including Registrations and Validation/Verification, Merits team).
- Mobilise employees within the Province to actively practice the RAF mission, vision, values and strategic objectives.
Ensure implementation of continuous improvements initiatives to enhance service delivery & effective reporting.
- Prepare and submit monthly progress reports to the Senior Claims Manager.
- Ensure effective and sufficient recording of daily activities of the Department.
- Ensure the timely completion of financial reports.
Ensure adherence to corporate governance within the team.
- Prepare and manage the annual budget for the CEC in accordance with legislation and RAF targets and goals.
- Prepare the annual administrative and human resource budget for the budget for the Department in the Region.
- Ensure that employees adhere to the PFMA.
- Monitor the departmental expenditure.
Stakeholder Management
- Facilitate communication with all levels of stakeholder contact.
- Ensure that the RAF values are adhered to in all dealings with stakeholders.
- Ensure adequate representation of the Fund in relevant external activities and events.
- Ensure a positive relationship with all internal and external stakeholders. Ensure external stakeholders are continuously engaged to improve relationships.
People Management.
- Provide leadership and inspire team members towards high performance.
- Manage performance and development of reporting staff.
- Provide coaching to team members on an ongoing basis.
- Set operational goals and targets for teams.
- Ensure proper planning and allocation of consistent workload within the Department.
- Facilitate weekly team lead meetings to ensure maintenance of the crucial interface between management and staff.
Qualifications
- NQF 7 (Bachelor’s Degree or Advanced Diploma) related qualification to discipline.
- NQF8 (Post graduate Diploma / Honors Degree / Professional Qualification Degree) Advantageous.
Experience
- 6-8 working experience in a claims/legal environment of which 2 years must have been at a manager/supervisory level.
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Key Performance Areas
Policy and Strategy Review and Implementation
- Provide input into the enhancement and implementation of the case management strategy and plan that ensure alignment with short-term and long-term objectives.
- Keep up to date with effective case management policy and practice execution strategies
Case Management and Administration
- Manage all assigned cases.
- Manage the appointment of caregivers and the provision of the necessary training.
- Ensure that case management programs objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained.
- Present cases at case rounds/conferences to obtain multidisciplinary perpective & recommendations to achieve optimal outcomes.
- Manage the provision of claimants/ caregiver care plan and compliance reporting.
- Manage claimants case management plans, authorizations, assessment, and levels of care.
- Manager the review of medical records to identify specific medical issues.
- Manager the development of practice and/or clinical guidelines for cost effective rehabilitation of care.
- Identify financial and business risks to the Fund and escalate accordingly.
Management of Claimant Rehabilitation Care
- Manage claimants progress and outcomes
- Manage and analyse the determination of the claimant needs and coordinate reasonable recommendations for all the necessary and identified modifications in line with the nature of claimant's medical condition.
- Manage an in-home assessments by Senior Officer: Field Case management to assess members overall health needs, which includes medication reconciliation.
- Manage the identification of gaps in care as claimants transition from a care facility back to their home.
- Provide management direction and guidance in ensuring that healthcare services are accounted for by liaising with relevant personnel for authorisations and ensuring compliance with case management procedures, staandards, and protocols.
- Manage the approval and appointment of service providers in line with the defined scope of work.
- Determine the suitable rehabilitation stay for the claimant based on the required level of care and monitor the implementation.
- Ensure that an ongoing support to the family is provided on coping mechanisims post discharge.
- Manage and monitor the rehabilitation plans of the claimant/ client for effectiveness.
Integrating of Back to work and Community
- Corporate with the treating physician to obtain full or conditional release to return to work before injury becomes a lost time claim where ot is neccessary.
- Coordinates with the employer to develop a modified duty job for the injured worker who cannot immediately return ro his/her full pre-injury employment where required.
- Ensure succesful integration of the claimant back to the family and educate the claimant and family on the condition of the claimant.
- Identify community resources based on the claimants need.
Manage the Submission of Invoices
- Validate and quality assure invoices submitted to ensure that they are aligned to the services and treatments caimed for.
- Put measures in place to guard against the submission of fraudulent invoices.
- Manage the compliance of invoiced services from service providers and ensure validity in line with RAF Act and guidelines.
- Manage timeous payment of service providers.
Reporting
- Manage the completion of all relevant reports (timesheets, expenses, program specific reports) as per specified timelines and required standards.
- Provide report on all assigned cases, and the monthly rehabilitation reports of the claimants.
- Prepare and submit monthly and quarterly performance case management reports or as and when required to provide progress updates and/or inform management decisions.
- Ensure complete, timely, and accurate reporting with appropriate levels of escalation.
- Provide reports on the possibilities of back to work integration for claimants.
- Reporting on the cost associated with the undertaking certificate against what has been spent on care givers.
Stakeholder Management
- Build productive relationships with healthcare professionals to ensure adequate referral rates to achieve budgeted occupancy level.
- Ensure accurate service knowledge and advice and keep stakeholders informed of products and service options.
- Resolve stakeholder queries and complaints promptly.
- Manage relations with service providers and health professionals to ensure adherence in line with the protocols and service level agreement.
People Management
- Ensure the sourcing, development and retention of high-performance team.
- Manage the recruitment of operational workforce in line with employment equity targets
- Manage staff in the department to ensure that they achieve their objectives in line with 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/ Advanced Diploma in Health Sciences or Medical related Degree.
- Postgraduate in Health Sciences or Medical related qualification will be an added advantage.
- Registration with the relevant Health professional body
Experience
- Relevant 6-8 years' experience in Nursing or Case Management environment of which 2 (two) years must have been on a management/ supervisory level/ area of expertise.
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Key Performance Areas
Policy and Strategy Review and Implementation
- Provide input into the enhancement and implementation of the case management strategy and plan that ensure alignment with short-term and long-term objectives.
- Keep up to date with effective case management policy and practice execution strategies
Case Management and Administration
- Manage all assigned cases.
- Manage the appointment of caregivers and the provision of the necessary training.
- Ensure that case management programs objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained.
- Present cases at case rounds/conferences to obtain multidisciplinary perpective & recommendations to achieve optimal outcomes.
- Manage the provision of claimants/ caregiver care plan and compliance reporting.
- Manage claimants case management plans, authorizations, assessment, and levels of care.
- Manager the review of medical records to identify specific medical issues.
- Manager the development of practice and/or clinical guidelines for cost effective rehabilitation of care.
- Identify financial and business risks to the Fund and escalate accordingly.
Management of Claimant Rehabilitation Care
- Manage claimants progress and outcomes
- Manage and analyse the determination of the claimant needs and coordinate reasonable recommendations for all the necessary and identified modifications in line with the nature of claimant's medical condition.
- Manage an in-home assessments by Senior Officer: Field Case management to assess members overall health needs, which includes medication reconciliation.
- Manage the identification of gaps in care as claimants transition from a care facility back to their home.
- Provide management direction and guidance in ensuring that healthcare services are accounted for by liaising with relevant personnel for authorisations and ensuring compliance with case management procedures, staandards, and protocols.
- Manage the approval and appointment of service providers in line with the defined scope of work.
- Determine the suitable rehabilitation stay for the claimant based on the required level of care and monitor the implementation.
- Ensure that an ongoing support to the family is provided on coping mechanisims post discharge.
- Manage and monitor the rehabilitation plans of the claimant/ client for effectiveness.
Integrating of Back to work and Community
- Corporate with the treating physician to obtain full or conditional release to return to work before injury becomes a lost time claim where ot is neccessary.
- Coordinates with the employer to develop a modified duty job for the injured worker who cannot immediately return ro his/her full pre-injury employment where required.
- Ensure succesful integration of the claimant back to the family and educate the claimant and family on the condition of the claimant.
- Identify community resources based on the claimants need.
Manage the Submission of Invoices
- Validate and quality assure invoices submitted to ensure that they are aligned to the services and treatments caimed for.
- Put measures in place to guard against the submission of fraudulent invoices.
- Manage the compliance of invoiced services from service providers and ensure validity in line with RAF Act and guidelines.
- Manage timeous payment of service providers.
Reporting
- Manage the completion of all relevant reports (timesheets, expenses, program specific reports) as per specified timelines and required standards.
- Provide report on all assigned cases, and the monthly rehabilitation reports of the claimants.
- Prepare and submit monthly and quarterly performance case management reports or as and when required to provide progress updates and/or inform management decisions.
- Ensure complete, timely, and accurate reporting with appropriate levels of escalation.
- Provide reports on the possibilities of back to work integration for claimants.
- Reporting on the cost associated with the undertaking certificate against what has been spent on care givers.
Stakeholder Management
- Build productive relationships with healthcare professionals to ensure adequate referral rates to achieve budgeted occupancy level.
- Ensure accurate service knowledge and advice and keep stakeholders informed of products and service options.
- Resolve stakeholder queries and complaints promptly.
- Manage relations with service providers and health professionals to ensure adherence in line with the protocols and service level agreement.
People Management
- Ensure the sourcing, development and retention of high-performance team.
- Manage the recruitment of operational workforce in line with employment equity targets
- Manage staff in the department to ensure that they achieve their objectives in line with 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/ Advanced Diploma in Health Sciences or Medical related Degree.
- Postgraduate in Health Sciences or Medical related qualification will be an added advantage.
- Registration with the relevant Health professional body
Experience
- Relevant 6-8 years' experience in Nursing or Case Management environment of which 2 (two) years must have been on a management/ supervisory level/ area of expertise.
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Key Performance Areas
Policy review and implementation.
- Provide input into the enhancement and implementation of the case management policies and strategy and plan to ensure an alignment with short term and long-term objectives
- Manage the implementation of the case management strategy approved, including as appropriate any special tasks or projects requested by management
Clinical care management
- Manage the clinical status of claimants in accordance with the prescribed requirements throughout the case management process
- Manage the provision of clinical assessments to ensure that admissions adhere to approved criteria
- Ensure an accurate, appropriate, and complete diagnostic and procedural coding of all claimants’ records
- Manage the assessment of medical problems of the injured and the provision of quality of care
- Identify training needs of the Senior Officers: Hospital Case Management in line with the scope of work and the changes in the processes.
Manage the provision of patient care
- Substantiate claimant hospitalization in terms of treatment, length of stay and level of care
- Ensure that a comprehensive assessment for claimants is performed and that a follow-up in accordance with the schedule determined/ agreed is undertaken.
- Ensure the monitoring of claimant treatment recovery progress to recommend adjustments where necessary
- Ensure that the claimants focused plan of care is coordinated and communicated to ensure attention is being focused on progression towards discharge.
- Ensure that the quality of health care provided to claimant is monitored to ensure they are up to acceptable standards.
- Manage and ensure that the discharge plan for the claimant is effective and allows for continued treatment after hospital discharge
- Ensure that claimants have the necessary utilities and amenities required for complete recovery
- Provide alternative treatment options to ensure a cost effective and efficient plan of care
- Manage and fast track case management reports and recommendations relating to the issuing of Undertaking Certificate and Interim Undertaking Certificates.
- Analyze and approve the recommendations for the transfer of claimants to better facilities of care
Case management and administration
- Manage all assigned cases
- Manage the development of practice and/or clinical guidelines for cost effective care
- Intervene on clinical discussion relating to the care of MVA claimants as per the SLA and MOU
- Present cases at case rounds/ conferences to obtain multidisciplinary perspective and recommendations to achieve optimal outcomes
- Manage the provision of claimants care plan and compliance reporting
- Manage claimants case management plans, authorizations, assessment, and levels of care
- Manage the review of medical records to identify specific medical issues
- Identify financial and business risks to the Fund and escalate accordingly
- Analyze claimants care reports and make recommendation in preparation of the rehabilitation handover post discharge
- Manage high cost hospital cases and establish a forum for case managers to present high cost cases
Manage the submission of invoices
- Validate and quality assure invoices submitted to ensure that they are aligned to the services and treatments claimed for
- Ensure financial and case management documentation supports accurate record-keeping and future requirements
- Put measures in place to safeguard against the submission of fraudulent invoices
- Manage the compliance of invoiced services from service providers and ensure validity in line with RAF Act and guidelines
- Manage timeous payment of healthcare professionals for service rendered
Reporting
- Prepare and submit monthly and quarterly performance reports or as and when required to provide progress updates and/or inform management decisions
- Develop functional reporting systems for case 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
- Engage in hospital visits where needed to build stakeholder relationships, proactively resolve queries and increase visibility to claimants
- Build productive relationship with healthcare professionals to ensure adequate referral rates to achieve budgeted occupancy level
- Build professional, long-term relationships with Funders and other stakeholders
- Ensure accurate service knowledge and advice and keep stakeholders informed of products and service options
- Manage the resolution of stakeholder queries and complaints promptly.
People Management
- Ensure the sourcing, development and retention of a high-performance team
- Manage the recruitment of the operational workforce in line with employment equity targets
- Manage staff in the department to ensure that they achieve their objectives in line with the strategic objectives of the RAF
- Manage the implementation of human capital processes and procedures to control/ regulate workplace conflict and/or institute corrective measures and consultation processes to address deviations from standards
- Allocate, direct, motivate and evaluate subordinates to help them achieve their individual goals.
Qualifications and Experience
- Bachelor’s Degree / Advanced Diploma in a Health sciences or Medical related Degree..
- Postgraduate in Health Sciences or Medical related qualification will be an added advantage
- Registration with the relevant Health professional body
- Relevant 6-8 years’ experience in Nursing or Case Management environment of which 2 years must have been on a management/supervisory level/area of expertise
- ICU/Theatre or High cost Case Management experience will be an advantage.
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Key Performance Areas
Field Case Management
- Activate an undertaking certificate and compile a case management report
- Conduct a home visit and educate the claimant on offerings of the undertaking and explain about the overall process to be followed
- Conduct follow up assessments and make recommendations on claimants needs as per the assessment
- Coordinate the referrals to service providers aligned to the claimants needs as per the undertaking certificate
- Ensure successful integration of the claimant back to the family and educate the claimant and family on the condition of the claimant
- Facilitate timely consultation with appropriate medical service providers
- Provide vocational guidance after life changing event for client and possible back to work opportunities
Rehabilitation Services
- Monitor the rehabilitation of the claimant post discharge
- Monitor the drug utilisation and application review therof
- Assess the level of care giver and the financial implications /salary therof
- Determine claimant needs and facilitate reasonable recommendations for home and car modifications based on the nature of the claimant's medical condition
- Co-ordination of admission and request the necessary authorisations as per the caregiver SOP and guidelines
- Co-ordinate and faciltate transfer to the hospital for admission
- Facilitate the appointment of caregivers between the claimant and the caregiver, provide guidance on the process
- Co-ordinate the monthly submission of time sheets for payment processing
Facilitate the accuracy and effective submission of invoices
- 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 invoices to curb over servicing or abuse and fraudulent claims
- Ensure that the accounts are paid timeously, according to service level agreements
- Ensure that services and treatments claimed for are accident related (related to the accident under consideration)
- Compare outcomes and cost of different therapeutic modalities and surgical techniques and the information provided is invaluable in developing guidelines for clinical management
Reporting
- Compile and update case management reports for the injured.
- Provide a report on patient care and ongoing rehabilitation.
- Reporting on the service by service providers.
Stakeholder management
- Drive the stakeholder interaction needed to facilitate the level of care
- Maintain relations with different levels of health specialst to enable smooth interactions
- Participate in the awareness of RAF case management services in the communities
- Communicate with all levels of stakeholders
- Participate in relevant external RAF activities and events
- Ongoing engagements with service providers
Qualifications
- Bachelor's Degree or Advanced Diploma in Nursing/Allied Health Prefessions or related qualification
- Registration with the relevant Health Professions Council.
Experience
- Relevant 4 years’ experience in the Medical environment.
- Experience in Managed Healthcare environment.
- Valid code 8 driving license.
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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.
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Key Performance Areas
Combined Assurance
- Coordinate the development of the Integrated Combined Assurance Plan.
- Evaluate combined assurance initiatives by assurance providers and link the reviews to the strategic risks and root causes.
- Track and monitor emerging and manifested risks.
- Keep track of all assurance providers' recommendations.
- Identify inconsistencies presented by assurance providers on the control environment through evaluation of existing and future controls, including identified control gaps. Monitor implementation of approved integrated combined assurance plan and identify assurance coverage risks.
Quality Assurance and Management
- Perform Quality Assurance reviews on selected assurance work done by assurance providers.
- Analyse and evaluate the adequacy and effectiveness of assurance providers’ processes and procedures/ methodologies and recommend improvements to ensure effectiveness of monitoring and oversight procedures.
- Create an intergrated dashboard for combined assurance.
- Coordinate and implement of joint map results to provide a comprehensive perspective of all concerns for management to resolve.
- Conduct Combined Assurance reviews and impact assessment.
- Acquire and manage the combined assurance/ internal control system/ tool.
Internal Controls
- Recommend the design and implementation of effective internal system control to management and relevant parties.
- Coordinate the testing of key controls for RAF.
- Manage independent and objective assessments of internal controls, financial results, RAF processes and adherence to compliance requirements.
- Provide or coordinate advisory services to management and process owners on internal control requirements.
- Recommend improvements in procedures and systems in order to improve the internal control environment (maturity level) within RAF.
- Analyse risk registers to identify control gaps and recommend reviews by assurance providers.
Policy Review and Implementation
- Contribute to the development of Combined Assurance Framework, policies, procedures and guidelines; and guide the process through the alignment of the documents to the overall RAF’s Strategy.
- Keep up to date with effective policy and practice execution strategies.
Reporting
- Prepare regulation reports as and when required to provide progress, updates, make recommendations to inform management decisions.
- 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 writting.
Stakeholder Management
- Support relationship building with internal and external stakeholders to facilitate performance of assurance engagements and exchange of knowledge on assurance best practice.
- Build relationship with internal and external stakeholders to facilitate performance of assurance engagements and identify appropriate areas of management support.
- Mantain relationships with vendors, service providers or procurement teams and ensure that all relevant procured items are invoiced and paid on time.
- Advise management on effective control measures, systems and fraud prevention measures.
- Represent the Fund in relevant external activities and events.
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.
- Ensure capacity development of staff and identify appropriate developmental opportunities.
- Manage performance of staff, mentor and couch staff.
Qualifications and Experience
- Bachelor’s Degree/ Advanced Diploma in a Data Management related qualification.
- Relevant 5-7 years’ experience in a data management/reporting related environment.
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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.
Business needs and requirements
- Gather the requirements from users.
- Analyse user requirements.
- Document user requirements.
- Validate documented requirements with the user and get signoff.
Feasibility Studies
- Research on proposed user requirement specifications.
- Identify benchmarks and best practices.
- Apply best practices and benchmarks to document proposal findings.
- Make suggestions and recommendations based on research findings.
Design Solution Proposal
- Design business process.
- Logical system design.
- Determine system data flow.
- Execute technical design:
- Database layout.
- User interface design.
- Schedule JAD session to sign off design specification.
- Ensure integration of new systems with enterprise systems.
System Testing
- Analyse changes requested by users (Change control).
- Assist developers in performing impact analysis on the system based on envisioned changes and recommend alternative solutions if necessary.
- Document changes and present then to developers.
System Training
- Assist system development team in system integration testing.
- Assist system test analyst in creation of test packs.
- Assist in documentation of bugs found during system testing and facilitate in fixing those bugs.
- Assist in system performance testing.
- Facilitate user acceptance testing.
- Ensure final product compiles with specifications.
- Get system sign-off prior to implementation.
Reporting
- Aid in the development of functional reporting systems, for management, project or performance reporting.
- Ensure regular and periodic reports are sent to the Manager for review and submitted as and when required to provide progress updates and/or inform management decisions.
- Development of proposals, briefings, presentations, reports, and other documentation and providing management information both verbally and in report format.
Documentation
- Maintain system technical & functional specifications documents.
- Maintain solution design documents.
- Provide the same during quality audit.
Stakeholder Management
- Maintain proactive and progressive relationships with key stakeholders.
- Deal with inquiries and requests for information from both internal and external stakeholders.
- Aid in the maintenance of relationships with vendors, service providers or procurement teams and ensure that all relevant procured items are invoiced and paid on time.
- Presentation of data findings in an easy-to-read and understandable format.
Qualifications and Experience
- Bachelor's Degree/ Advanced Diploma in Computer Science, Information Systems, Information Technology or Computer Engineering related qualification.
- Certificate in System Analysis and Design
- Certificate in ITIL will be an added advantage
- Relevant 5-7 years' experience in requirements gathering, system analysis and design environment.
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Key Performance Areas
Manage Healthcare Provider Network Processes
- Monitor and manage the quality of healthcare Provider Performance Networks and compliance in line with the SLA or MoU.
- Provide orientation, education, and general support for existing providers which includes conducting all face-to-face meetings and ad-hoc requests.
- Responsible for establishing and maintaining processes and systems to provide routine services to members including contract management.
Provider Administration
- Design database systems used to manage provider data.
- Resolve escalated issues arising from operations and requiring coordination with other departments.
- Design and execute on performance management processes to demonstrate network performance.
Policy Review and Implementation
- Contribute to the development and implementation of healthcare Network protocols.
- Contribute to the development and implementation of provider networks.
- Keep up to date with effective SOP’s, policy and practice execution strategies.
Reporting
- 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 to 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.
Qualifications and Experience
- Bachelor’s Degree/ Advanced Diploma in Clinical Sciences related qualification.
- Relevant 5 - 7 years’ work experience in the healthcare funding/ medical scheme industry of which 3 - 5 years’ experience in healthcare networks and/or provider relations is essential.
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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.
Business Analysis and Reporting
- Analyse data concerning business activities within RAF. Provide suggestions for improved performance and efficiencies.
- Collect data from different business units and maintain data collection systems. Suggest other strategies that optimize statistical efficiency and quality.
- Suggest improved/ enhanced RAF processes and systems based on analytic outcomes.
- Conduct research activities and analysis to come up with business solutions.
- Keep up-to-date with advancements in the business analytic field.
- Provide outcomes to the Senior Business Analyst if anomalies and discrepancies are found.
Business Process Improvement
- Use of tools to enable continuous process improvement within the RAF.
- Analyse and improve business processes.
- Implementation of process maps, flow diagrams and related documentation for redesigned processes.
- Collaborate with systems developers within RAF to align system functions and set-up with optimized business processes and ensure both business and technical suitability.
- Conduct thorough diagnosis of business processes and operations, document and present recommendations and provide detailed assessment of cost, benefits and risks.
Reporting
- Aid in the development of functional reporting systems, for management, project or performance reporting.
- Ensure regular and periodic reports are sent to the Manager for review and submitted as and when required to provide progress updates and/or inform management decisions.
- Development of proposals, briefings, presentations, reports, and other documentation and providing management information both verbally and in report format.
Stakeholder Management
- Maintain proactive and progressive relationships with key stakeholders.
- Deal with inquiries and requests for information from both internal and external stakeholders.
- Aid in the maintenance of relationships with vendors, service providers or procurement teams and ensure that all relevant procured items are invoiced and paid on time.
- Presentation of data findings in an easy-to-read and understandable format.
Qualifications and Experience
- Bachelor's Degree/ Advanced Diploma in Information Systems/ Business Analysis/ Business Management, /Data Modelling / Statistics related qualification.
- Relevant 5-7 years' experience in a business analysis environment.
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Key Performance Areas
Cyber Security
- Develop, implement, and monitor a strategic cyber security program to protect enterprise IT assets.
- Manage the implementation of effective incident response and recovery plans, enabling the organization to quickly respond to and recover from security incidents.
- Ensure the governance structure and processes for the department are reviewed and manage the implementation thereof.
- Manage the alignment of technology governance with corporate governance.
- Manage the development of periodic reports on operational excellence and cost reductions achieved.
- Oversee risk assessments regarding cyber security and penetration testing.
- Manage the development of cyber security awareness training for the organization.
- Assess current technologies and recommend hardware or software tools to top management.
- Drive the adoption of best ICT and cyber security practices across the organization.
Policy Review and Implementation
- Contribute to the development and implementation of departmental policy, procedures and processes.
- Ensure the organization complies with regulatory requirements and industry best practices related to ICT and cyber security.
Reporting
- Prepare and submit regulation reports as required to provide progress updates and inform management decisions.
- Develop 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.
Stakeholder Management
- Facilitate and manage communication with relevant internal and external stakeholders in relation to investments and proactively and progressively manage the relationships.
- Communicate with all levels of stakeholder contact.
People Management
- Lead, mentor, and develop the ICT and Cyber Security teams, fostering a culture of continuous improvement and innovation.
- Manage resource allocation, including budgeting for system maintenance, upgrades, and security projects.
- Manage the implementation of human capital processes and procedures to control or regulate workplace conflict and institute corrective measures and consultation processes to address standard deviations.
Qualifications and Experience
- Bachelor’s Degree/ Advanced Diploma in Information Technology or a Computer Science related qualification.
- A postgraduate in Information Technology or a Computer Science related qualification will be an added advantage.
- Being a Certified Information Systems Security Professional (CISSP), CISM, CISA, or similar certifications will be advantageous.
- Relevant 6 - 8 years experience in an Information Technology/ Risk Management related environment of which 2 years must have been on a management/ supervisory level/ area of expertise.
- Relevant certifications such as CISSP/ CISM/ CISA or ITIL are advantageous.
- Strong understanding of current ICT technologies, cyber security trends, and best practices.
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Key Performance Areas
IT Strategy and Governance
- Develop and implement operational plans that align with the Head of Department: Technology and Digital’s strategic vision and RAF’s goals.
- Manage project portfolios within the Head of Department’s office, ensuring efficient resource allocation and timely completion.
- Track progress on key Technology and Digital initiatives and report on achievements to the Head of Department and other stakeholders.
- Conduct regular Technology and Digital governance meetings to review strategies and compliance.
- Utilise Technology and Digital audits and assessments to ensure governance standards are met.
Project and Portfolio Management
- Application of project management methodologies (e.g. Agile) to manage Technology and Digital projects.
- Portfolio analysis to prioritise projects based on strategic value and resource availability in collaborations with other stakeholders (for e.g., ePMO, Business Relationship Management).
- Regular project reviews and adjustments based on performance metrics.
IT Operations and Service Delivery
- Ensure, together with the Technology and Digital Cybersecurity and End-user Computing functions, the implementation of IT Service Management (ITSM) practices to streamline operations.
- Monitoring IT Infrastructure to ensure reliability and performance.
- Ensure that Service Level Agreements are established and reviewed, together with other stakeholders, with internal and external service providers.
Budget and Financial Management
- Develop and manage the budget for Head of Department: Technology and Digital, ensuring responsible resource allocation and expenditure control.
- Track and analyse budget variances, identify areas for cost optimisation.
- Secure resources and funding for Technology and Digital projects and initiatives, justifying expenditures in line with business goals.
- Track and analyse the Technology and Digital budget overall and reporting on budget variances as well as identify cost optimisation opportunities.
- Ensure effective allocation of resources to support strategic initiatives.
Leadership and Team Development
- Lead and develop the Technology and Digital team, fostering a culture of continuous improvement, innovation and collaboration.
- Facilitate leadership development programmes and team-building activities.
- Implement performance management processes for continuous feedback and improvement.
Operational Efficiency and Effectiveness
- Streamline processes within the Head of Department: Technology and Digital office to optimise workflow and resource utilisation.
- Implement performance metrics and reporting systems to monitor Department effectiveness and identify areas of improvement.
- Foster a culture of continuous improvement within the team, encouraging innovation and problem-solving.
Stakeholder Management and Communication
- Serve as a liaison between Head of Department: Technology and Digital’s office, Technology and Digital teams, and other Business Units, fostering collaboration and clear communication.
- Effectively manage stakeholder expectations and address concerns proactively.
Reporting and Analysis
- Regular collection and analysis of digital adoption metrics.
- Creation of dashboards and reports for Senior Management.
- Use of analytics tools for data visualisation and insights generation
- Conducting Return on Investment analysis for digital initiatives.
- Presentation of findings and recommendation for continuous improvements.
Qualifications and Experience
- Bachelor’s Degree/ Advanced Diploma in Information Technology/ Computer Science/ Engineering/ Transportation/ Transportation/ Commercial/Business/ Administration/ Project Management or related qualification.
- Relevant 5 - 7 years’ experience in IT Management, with experience in leading IT projects, teams, and implementing IT strategies that align with business objectives.
- Experience in budget management, negotiations and contracting.
- Experience in working independently in a fast-paced and ever-changing environment.
- Experience in Project Management.
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Key Performance Areas
Digital Adoption Strategy Implementation
- Develop a digital adoption roadmap
- Stakeholder analysis and engagement planning.
- Align digital adoption strategies with the RAF’s operational objectives and cultural values.
Technology and Digital Internal Communications and Engagement
- Design of communication plans tailored to different audience segments.
- Conducting regular town hall meetings or digital forums
- Use of collaboration tools to facilitate discussion and feedback.
- Gather and analyse feedback from internal users to inform the continuous improvement of digital tools, technologies, and platforms, ensuring they meet the evolving needs of RAF.
Technology and Digital Content Creation and Management
- Development of content calendars for consistent messaging.
- Production of engaging multimedia content (video, infographics, blogs).
- Use of content management systems for publishing and analytics.
- Regular content performance review and optimisation.
Digital Marketing
- Execution of targeted email marketing campaigns.
- Social media management for internal platforms.
- Data-informed campaign planning based on internal user behaviour.
- A/B testing of digital marketing messages and channels.
- Analytics and reporting to measure campaign effectiveness.
Change Management
- Application of change management frameworks (e.g., ADKAR, Kotter’s 8-step Process, etc.).
- Development of training and support materials for new systems or processes
- Monitor and address resistance through feedback loops.
- Celebrate successes and quick qins to build momentum.
Reporting and Analysis
- Ensure preparation and submission of regulation reports.
- Report quarterly on progress within the area of focus.
- Ensure development of functional reporting systems, project or performance reporting for management.
- Ensure the development of reports/ policies/ procedures and guide the process through the alignment of these documents to the overall RAF’s Strategy.
- Ensure regular and periodic reports are prepared and submitted as and when required to provide progress updates and/or inform management decisions.
- Ensure governance committee reports are prepared promptly, professionally and in accordance with the respective committee’s standards and expectations.
Qualifications and Experience
- Bachelor’s Degree/ Advanced Diploma in Information Technology/ Computer Science/ Engineering/ Transportation/ Commercial/ Business related qualification.
- Postgraduate certification in either Communications or Marketing or Management would be advantageous.
- Relevant 5 - 7 years’ experience in digital adoption, internal communications, digital marketing, change management, or a related area.
Method of Application
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