17 Care Planning jobs in South Africa

Job Purpose
Before applying for this job, it is important that you read the guidance by clicking on this link and the Job Profile attached. These explain the job role and the type of person we're looking for.
Location:
Marischal College, Broad Street, Aberdeen

Duration:
Permanent, Full Time

Roles that require PVG Membership
Please note that with effect from 1 April 2023, where a role requires PVG membership, candidates will be required to meet the cost of the PVG membership. This applies
only
to roles with a full time equivalent salary of £30,000 and above. (Teaching roles and jobs at Grade 11 and above (currently £1,505 per annum / 7.31 per hour)

The Council will pay for the PVG membership cost initially, either 8 for existing PVG scheme members, or 9 for non-members, and this cost will be deducted from an employee's first FULL month's salary payment.

About The Role
To lead on the strategic and operational delivery of Adult Social Work and Adult Social Care across the Health & Social Care Partnership. To take responsibility for the discharge of Social Work statutory duties including duties in relation to Adult Support and Protection. To lead, support and advise on the professional and clinical delivery of social work across all operational services within the IJB.

The Post Holder Needs To Hold As a Minimum
Qualified Social Worker

Extensive experience at senior management level

Postgraduate qualification in a relevant subject

Evidence of continued professional development

Membership of Protection of Vulnerable Groups Scheme or willingness to join

Registration with SSSC

The Postholder Is Able To Demonstrate
Skills & Experience in:
Considerable senior management experience in operational social work

Ability to lead and motivate staff and to manage resources effectively

Complex budget management knowledge and competence, including financial resource planning and deployment and contingency planning

Innovative use of locality assets/resources

Ability to lead and motivate multi-sector and community partnerships

Experience in leading and delivering complex change

Proven interpersonal and negotiating skills

Excellent communication skills

IT literacy

Understanding Of
Clinical and professional role of social work services

Leading and empowering staff within a multi-disciplinary and multi-agency team

Considerable knowledge and competence in ensuring standards of clinical & care

governance, and their application, are well understood and adhered to within their

jurisdiction

Breadth of understanding/experience in managing and delivering complex service

provision and redesign

Competence in understanding and working within a democratic system of governance

In depth knowledge of legislation and policy

Working under pressure and to tight deadlines

Commitment To
The integration of health and social care

The vision, values, aims and priorities of Aberdeen City IJB

The Local Outcome Improvement Plan

The principles and aims of Aberdeen City Council

About Us
Please see the Job Profile for further details.

Aberdeen City Council is an equal opportunities employer and we are committed to equality, diversity and inclusion. For further information, please see our Equality, Diversity, Inclusion and Recruitment pack.

Flexible Working
We are happy to talk flexible working and offer flexible working for most roles in the organisation meaning that many of our employees enjoy the freedom of choosing a working pattern that suits them as much as it suits the organisation.

Disability Confident
We are a Disability Confident Employer. If you consider yourself to have a disability and think you may require a reasonable adjustment to be made for this part of the selection process, or would like further information in relation to reasonable adjustments, please contact

Armed Forces
We are a forces-friendly employer, have signed the Armed Forces Covenant and are a gold award recipient in the Defence Employer Recognition Scheme. We have a specific email address for those in the forces, those who have left the forces, as well as their partners / spouses / families: We are able to answer questions about jobs and our application / selection process, as well as about our employee support provisions.

Guaranteed Interview Scheme
Role
We have a number of guaranteed interview schemes available to applicants who meet the minimum criteria for the role they are applying for who:

• have a disability as defined by the Equality Act 2010 (all jobs)
• looked after young people, those that are in continuing care or are a care leaver up to the age of 29 (all jobs)
• are aged 16-24 and live in Aberdeen City or have been to an Aberdeen City Council school and are applying for a Modern Apprenticeship (except Trades apprenticeships)
• have done a Foundation Apprenticeship with Aberdeen City Council and are applying for any apprenticeships relevant to the area in which they did their Foundation Apprenticeship
• are New Scots aged 16-24 and are applying for any apprenticeships

Please note that eligibility to work in the UK is dependent on legal status and all applicants must have the right to live and work in the UK.

Further information can be found

Duties/Pligte

• Undergraduate teaching in the theoretical programme.
• Undergraduate teaching and coordinating a year group in the practice education programme.
• Postgraduate supervision.
• Research and publication.
• Participating in own and departmental social impact activities.

• Performing administrative tasks associated with the mentioned duties.

• Voorgraadse onderrig in die teoretiese program.

• Voorgraadse onderrig en koördinering van `n jaargroep in die praktykonderrigprogram.
• Nagraadse supervisie.
• Navorsing en publikasies.
• Deelname aan eie en departementele sosiale impak aktwiteite.
• Uitvoering van administratiewe take verbandhoudend met die genoemde pligte.

Job Requirements/Pos Vereistes

• PhD in Social Work, preferably in the field of child protection.
• Registration with the South African Council for Social Service Professions.
• Evidence of the ability to publish and present at conferences.
• Professionally proficient in English, and willingness to function in a multilingual environment.

• Relevant practice experience.

• PhD in Maatskaplike Werk, verkieslik op die vakgebied van kinderbeskermingsdienste.

• Registrasie by die Suid-Afrikaanse Raad vir Maatskaplike Diensberoepe.
• Bewese vemoë om te publiseer en om voordragte by konferensies te lewer.
• Professionele vaardigheid in Engels en bereidwilligheid om te funksioneer in ¿n meertalige omgewing.
• Toepaslike praktykervaring.

Recommendation/Aanbeveling

• Knowledge of the BSW Standards of the Social Work Curriculum in South Africa as stipulated by the CHE.
• Experience with supervising undergraduate students in a Social Work practice education programme.
• Knowledge and experience of online teaching and learning platforms.
• Experience with independent research.
• Strong leadership and teamwork capabilities.

• Excellent communication skills.

• Kennis van die MSW Standaarde van die Maatskaplike Werk Kurrikulum in Suid-Afrika soos gestipuleer deur die RHO.

• Ervaring van supervisie aan voorgraadse studente in 'n Maatskaplike Werk praktykonderrigprogram.
• Kennis en ervaring van aanlyn onderrig- en leerplatforms.
• Ervaring van onafhanklike navorsing.
• Sterk leierskap- en spanwerkvaardighede.
• Uitstekende kommunikasievaardighede.

Applications must include the following:

• A complete academic curriculum vitae.
• A list of at least three contactable referees.
• A one to two page cover letter where the candidate discuss their experience, research and teaching plans, and potential contribution to the Department of Social Work at Stellenbosch University.
• A teaching portfolio (optional).

Aansoeke moet die volgende insluit:

• 'n Volledige akademiese curriculum vitae.
• 'n Lys van minstens drie verwysingspersone wat gekontak kan word.
• 'n Een- tot twee-bladsy dekbrief waarin die kandidaat hul ervaring, navorsings- en onderrigplanne, asook moontlike bydrae tot die Departement Maatskaplike Werk aan die Universiteit

Stellenbosch uiteensit.

• 'n Onderrigportefeulje (opsioneel).

We are seeking a driven, detail-oriented, and highly organized Team Leader to oversee a case management team within the healthcare and insurance space. The ideal candidate is proactive, strategic, and accountable, with proven experience managing people and processes in case management, healthcare administration, or insurance operations.

This leader will be responsible for ensuring cases move forward accurately and on time, guiding the team, and serving as the key point of escalation for clients and stakeholders.

• Lead, supervise, and mentor a team of case managers and support staff.
• Oversee the full case management process from intake to resolution ensuring accuracy, compliance, and efficiency.
• Act as the main escalation point for clients, clinics, and insurance providers.
• Establish clear workflows, priorities, and performance standards for the team.
• Conduct quality checks to ensure meticulous handling of cases and documentation.
• Report regularly to management on team performance, case progress, and client satisfaction.
• Train and develop staff to strengthen process knowledge and case handling.

• 5+ years experience in healthcare administration, medical case management, insurance verification, or clinic operations.
• 2+ years in a leadership/supervisory role with responsibility for team performance.
• Strong knowledge of case management systems, insurance processes, and compliance requirements.
• Proven ability to think strategically, solve problems, and make sound decisions under pressure.
• Exceptional attention to detail and organizational skills.
  Excellent communication skills confident, professional, and client-facing.

• Meticulous and proactive, with a natural ability to spot gaps and ensure follow-through.
• Balances hands-on involvement with strategic leadership.
• Motivates others while holding them accountable.
• Thrives in a structured environment and ensures nothing falls through the cracks.

Why Join

• Lead a growing, high-impact healthcare/insurance operations team.
• Opportunity to shape workflows and establish best practices.
• Clear growth path into senior operations or client management roles.

Position Purpose:

To manage the clinical operations to ensure best clinical practice and success is achieved for members and that Service Level Agreements are met in order for the scheme and organisation to remain sustainable and stable

Experience:

8 years experience including:

Medical industry experience in Renal, Mental Health and Alternative to hospital.

4 years medical industry experience.

4 years management experience in medical industry.

Qualifications:

Registered Nurse with professional membership. Post basic qualification in management.

Accountabilities:

Compliance & Risk Management

• Ensure legal and regulatory compliance is upheld.
• Monitor and address operational risks and governance issues.

Financial Management

• Control expenses and identify cost-saving opportunities to meet financial targets.

Operating Model

• Develop and execute operational plans aligned with delivery goals.
• Improve internal processes and resolve operational conflicts.
• Drive performance against service level agreements and quality standards.
• Provide clinical oversight and manage clinical risks and outcomes.

Strategy Implementation

• Translate departmental business plans into actionable team strategies.
• Implement changes in response to external factors while maintaining best practices.
• Align team plans with Medscheme's strategic direction.

Operational Leadership

• Build and retain high-performing, motivated teams.
• Manage team performance and support staff development.
• Promote diversity and uphold Medscheme values.

Stakeholder Management

• Maintain strong relationships with customers and stakeholders.
• Address stakeholder needs and ensure effective treatment outcomes.
• Respond to queries from bodies like the Council of Medical Schemes and Marketing.

Generic Objectives

Specific Deliverables

Operational Leadership

• Select, retain and grow high performing teams
• Create highly motivated and engaged operating environments

Stakeholder Management

• Ensure stakeholder queries, clinical needs and amendments are implemented to maintain a successful relationship and ensure maximum effectiveness of treatments paid for
• Resolve queries and provide feedback for stakeholders such as the Council of Medical Schemes, Marketing and fund management

Operating Model

• Track and drive team to achieve and maintain defined service level agreements and turnaround times at the defined and approved quality standards
• Evaluate, enhance and implement processes and systems to improve profitability, effectiveness and organisational risk
• Provide clinical management, support and analysis where appropriate
• Analyse, assess and manage clinical outcomes and risks

Knowledge

-Understand and demonstrate agile development life cycles

-Knowledge and application of relevant legislation

Skills

• Ability to manage Clinical and Financial risks effectively
• Communication Skills
• Innovates and Takes Risks
• Task Management
• Executive Business Writing Skills
• Financial Acumen
• Neural Network Architecture
• Change Management
• Ability to evaluate clinical challenges and needs
• Quality Driven
• Computer Technology Skills

Turnaround Time

The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of line managers.

Our Commitment to Transformation

AfroCentric is committed to transformation and embracing diversity. Our Employment Equity plan and targets will be considered as part of the recruitment process. This commitment is what drives us to achieve a diverse workplace with employment equity as a key goal to create

Should you not receive feedback within a month of applying, please consider your application unsuccessful

?Assessment on all applications for dispute resolution to determine jurisdiction.

?Identification of issues in dispute in terms of Section 39 of the CSOS Act.

?Prepare Notice 43 and 44 in terms of the CSOS Act.

?Facilitate submissions received from various interested parties in terms of Section 44 of the CSOS Act.

?Set the matter down for a Conciliation hearing in terms of Section 47 of the CSOS Act.

?Prepare file for Conciliation hearing.

?Managing and capturing reports on case management system in the division.

?Assist with telephone complaints as well as walk-in applicants.

?Provide weekly feedback to complainants.

?Prepare monthly reports on all matters.

?Maintain diary of all matters.

?Assist with ad hoc administrative support and duties within the division.

?Degree in Law (NQF 7).

?2 ? 3 Years experience in Dispute Resolution processes or the legal environment,

?Knowledge of the Dispute Resolution process and Community Schemes.

?Deadline focused.

?Strong work ethic.

?Team player.

?Knowledge of computerized telephone management system.

?Basic administrative functional knowledge (typing and filing).

Position Purpose:

To lead the team and drive end to end processes in order to deliver a customer-centric business environment. Ensure that the operational area is aligned to Medscheme and client schemes strategic objectives. Provide holistic care that is personalised and accessible, managing the journey end to end. Commit to our service care charter striving to continuously make a positive difference.

Experience:

2 - 3 Years Operational experience and 2 years management experience advantageous

2 years Leadership experience

1 year Experience in Quality Assurance, Workforce Planning and Recruitment

Qualifications:

Diploma in General Nursing and a Degree/Diploma in ICU

Compliance and Risk Management

• Defined legal, statutory and regulatory compliance is appropriately implemented and maintained at the required standards for the team

• Implemented team operational risk and governance structures, measures and frameworks are monitored and necessary action is taken to address issues, when necessary

Financial Management

• Manage expenses and costs and identify cost saving opportunities to support the department in achieving its financial goals and targets

Operating Model

• Implement team operational plans and manage that the defined delivery objectives are met through supporting, and being supported by other teams within and linked to the department / project

• Identify opportunities to improve the team's core operational internal processes and internal supply chain

• Resolve team operational conflicts

• Ensure delivery targets/objectives are met and motivate the team to operate in a mutually supportive manner to achieve successful delivery

Operational Implementation of Strategy

• Plan and implement daily, weekly and/or quarterly operational changes within the team to respond to important external influences

• Ensure relevant sections of the business plan are implemented in a manner that supports operational quality and meets the defined departmental priorities

• Communicate the relevant sections of the team operational plan to facilitate buy-in of the employees

• Ensure implementation of workplans in a way that maintains operational best practice and leads to continuous delivery improvement

Operational Leadership

• Manage the operational performance of the team as per HR frameworks and policies to ensure delivery to agreed standards and objectives

• Provide appropriate staff development, coaching and mentoring and retain skilled and engaged employees within the team and Medscheme

• Support transformation through valuing diversity within the team and department

• Behave in alignment with the Medscheme values

Stakeholder Management

-We are looking for a dynamic and results-driven leader to join our team, someone who can drive operational excellence, stakeholder engagement, and strategic delivery. The ideal candidate will ensure legal, statutory, and regulatory compliance is upheld, while implementing effective risk and governance frameworks. You will manage departmental expenses, identify cost-saving opportunities, and support financial targets. This role requires strong operational leadership, including the implementation of team plans, resolution of conflicts, and continuous improvement of internal processes. You will lead daily, weekly, and quarterly operational changes aligned with business priorities, ensuring best practices and consistent delivery. A key part of the role involves managing team performance, coaching and mentoring staff, fostering diversity, and creating a safe, engaging work environment. You will build and maintain strong relationships with internal and external stakeholders, address concerns professionally, and collaborate across departments to ensure timely resolutions. Additional responsibilities include onboarding new employees, maintaining quality standards, supporting ISO and compliance requirements, conducting performance reviews, and representing business capabilities in governance forums. You will also oversee resource planning, manage service levels, monitor trends, and drive customer satisfaction. Embracing digital transformation and agile methodologies is essential, as is the ability to adapt to changing business needs and ensure continuity during unplanned downtime. If you are passionate about leading teams, driving strategic outcomes, and making a meaningful impact, we invite you to apply.

Generic Objectives

People Leadership:

-Lead and inspire your people and drive team collaboration.

-Develop and support your people growth by focusing on their strengths

and styles.

-Coach and enable team to maximise their potential.

-Empower your people with skills to improve confidence, knowledge and communication

skills.

-Amplify your people's imagination and self

-learning.

-Create a safe and happy working environment that inspires all, adapting to needs of

your people.

-Manage, monitor leave and wellness of your people.

-Recognise and appreciate excellence and team collaboration in real

-time.

Continuous improvement:

-Identify areas of improvement and solving for sustainable solutions through root cause analysis, lean six sigma methodologies

and feedback loops.

-Assist with user acceptance testing and coach your teams through changes.

-Demonstrate excellence in communication and daily

performance management.

Workforce Management:

-Perform Resource planning, forecasting and management across all channels and touch points.

-Manage and plan downtime when required.

-Manage work volume and ensure service levels are met and improved.

Business Continuity Management:

-Understand how to manage business continuity and unplanned downtime.

-Manage incidents and service level

continuity.

Manage and Maintain Operational Content:

-Represent the business capability in the organisation's governance model.

-Collaborate with solution

capabilities and product owners to ensure operational content enables the implementation of all business strategies.

-Manage and maintain consistency

of all Standard Operating Processes and Operational Resources by working collaboratively with capability owners and forums.

-Attend and participate

in all required forums in the governance model, supporting all roles in the business model.

Manage Performance:

-Motivate the team to achieve the organisational goals.

-Manage timelines and priorities to ensure business goals are met.

-Conduct performance reviews and align to frequent coaching.

-Provide exceptional organisation and focus for the team. Conduct performance management.

Recruitment Management:

-Manage and adhere to all recruitment policies and processes.

-Empower and enable new employees ensuring all resources are

ready to ensure a seamless and engaging on boarding.

Relationship Management:

-Collaborate and manage all stakeholders proactively.

-Understand your stakeholders needs.

-Build and establish relationships

at all levels with external partners and internal departments so ensure that timeous resolutions are found to any problems that may arise.

-Develop, maintain and improve consistent client communication and engagements. Be a brand ambassador.

Perception Management:

-Support the business objectives and drive customer satisfaction through the required metrics.

-Monitor trends and provide

possible improvements. Lead the delivery of excellence in customer satisfaction.

Quality Management:

-Manage the implementation of the Quality Management Framework with adherence to standards.

-Empower and drive the ISO and compliance requirements set by the business, monitor and improve.

-Perform quality evaluations for team members and peer to peer

reviews. Understand and drive digital transformation:

-Understand and embrace technology and attributes required in a Digital Environment.

-Empower

the digital agile way of working to optimise efficiencies, improve communication and collaboration.

Knowledge

-Health Care Industry

-Knowledge and application of relevant legislation and regulations

-Knowledge, application and improvement of policies and procedures

Turnaround Time

The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of line managers.

Our Commitment to Transformation

AfroCentric is committed to transformation and embracing diversity. Our Employment Equity plan and targets will be considered as part of the recruitment process. This commitment is what drives us to achieve a diverse workplace with employment equity as a key goal to create

Should you not receive feedback within a month of applying, please consider your application unsuccessful

The Department of Social Development, Western Cape Government has opportunities for suitably qualified and competent Social Auxiliary Workers to provide assistance and support to Social Workers with the promotion of social change, problem solving in human relationships and the empowerment and liberation of people to enhance social well-being under the guidance and supervision of the Social Worker.

Grade 1: Grade 10 plus completion of the learnership to allow registration with the South African Council for Social Service Professions (SACSSP) as Social Auxiliary Worker; Registration with the SACSSP as Social Auxiliary Worker; A valid code B driving licence.

None.

Provide assistance and support to social workers with the rendering of a social work service with regard to the care, support, protection and development of vulnerable individuals, groups, families and communities through the relevant departmental programmes; Assist social workers to attend to any other matters that could result in, or stem from, social instability in any form; Continuous professional development; Perform administrative support functions in support of social workers as required of the job.

Knowledge and basic understanding of the following: Human behaviour, relationship system and social issues; South African Social Welfare context the policy and practice of developmental social welfare services; South African judicial system and the legislation governing and impacting of social auxiliary work; Basic knowledge of financial matters related to social auxiliary work; Good communication (written and verbal); Proven computer literacy; Information and Knowledge Management (Keep precise records and compile accurate reports); Organising and planning skills; Presentation and facilitation skills; Report writing skills; Problem solving and analytical skills; Client orientation and customer focus skills.

Grade 1: R Grade 3: R per annum (as prescribed by OSD).

Note on remuneration: to-employer (CTE) remuneration packages for certain occupation-specific dispensations (OSD), the middle-management service (MMS) and contract positions are inclusive of all costs related to service benefits or obligations including basic salary, 13th cheque, medical assistance, housing assistance, pension-fund contributions, etc. MMS remuneration packages are flexible and may be individually structured as prescribed. Where remuneration is not indicated as CTE, employees' service benefits or obligations are funded or co-funded in terms of the applicable prescripts or collective agreements.

Shortlisted candidates will be required to submit copies of their documentation for verification purposes. These candidates will be required to complete a practical assessment and attend the interview on a date and time as determined by the department and may also be required to undergo competency assessments/proficiency test. The selection process will be guided by the EE targets of the employing department.

By applying for this position, you are consenting to the Western Cape Government contacting your previous employers/managers for an employment reference. Reference checks will include enquiries relating to your disciplinary records and reasons for leaving.

Should you experience difficulties with your online application, kindly note that technical support (challenges with online application) is only available from Monday to Friday from 08:00 to You may contact the helpline at Otherwise, all other queries relating to the position, kindly contact the enquiries person as indicated in the advert. Please ensure that you submit your application before the closing date as no late applications will be considered.

Division: 3300

Reference No: 6037

Location:

Johannesburg, Gauteng, ZA

Employment Type: Permanent

Disability (EE targeted role): No

T.A.S.K Grade: 12

Job Posting Salary: R579,259.00

Job Posting End Date: 30 Sep 2025

The Road Accident Fund's mission is to provide appropriate cover to all road users within the borders of South Africa; to rehabilitate and compensate persons injured as a result of motor vehicle accidents in a timely and caring manner; and to actively promote safe use of our roads.
Purpose of the job:
The
Senior Officer: Hospital
Case Management
is accountable for the coordination of medical care for motor vehicle accident patients/claimants in Hospitals.

Key Performance Areas
Assessment Of Injuries

• Assess extent of injuries on admitted patients.
• Daily assessment of patient according to prescribed measurements.
• Conduct daily patient scoring and data collecting.
• Monitor quality of care.
• Select and monitor clinical pathways.
• Identify patients' needs.
• Identify and record pre-existing conditions.

Facilitate Patient Care

• Facilitate multi-disciplinary patient care where appropriate.
• Facilitate timely transfers into the appropriate levels of care.
• Coordinate the admission and pre authorisations of the transfers.
• Coordinate and provide neccessary health education.
• Discharge planning and vocational guidance for the afterlife changing event for client.
• Drug utilization review.
• Proper handover to Field Case Management for continuation of care.

Patient Advocacy

• Cost Benefits analysis of the medical services.
• Liason between patient and care team to ensure common understanding and conflict resolution.
• Negotiate and procure resource services from providers.
• Ensure that patient confidentiality is maintained by all parties.

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 Hospital Case Management reports.
• Recommend issuing of Undertaking Certificate.
• Provide a reasonableness report of patient care in preparation of the rehabilitation post discharge.

Stakeholder Management

• Communicate with all levels of stakeholders.
• Participate in relevant external RAF activities and events
• Ongoing engagements with service providers.

Qualifications

• Bachelor's Degree/ Advanced Diploma in Nursing/ Allied Health Professions or related qualification
• Registration with the relevant Health Professional Council body

Experience

• Relevant 4 years' experience in the Medical environment.
• Experience in Managed Healthcare.
• Knowledge of ICD and CPT coding will be an advantage.
• Valid code 08 driving license.

Competencies

• Behavioural

• Planning, Organising and Coordinating

• Personal Mastery
• Emotional wisdom and decision making
• Ethics and Values

• Client Service Orientation

• Technical

• Core specialities in the case management process.

• Knowledge of healthcare operations.
• Ability to maintain patient confidentiality.
• Full knowledge of medical tariffs, treatment plans.
• Coding standards and protocols.
• Knowledge of PFMA to be able to analyse different requirements as per the claimants.

NB: "RAF offers Total Employment Cost packages with no additional contributions from the Employer, successful candidates are required to structure their packages in a manner that will suit their needs."
The Road Accident Fund subscribes to the principles of employment equity and preference will be given to People with Disabilities.
Applicants who have not received any correspondence from us within six weeks from the closing date can consider themselves unsuccessful
Security Vetting shall be conducted on all prospective employees
It is the applicants' responsibility to have foreign qualification evaluated by the South African Qualification Authority (SAQA) and to provide proof of such evaluation.

Division: 3300

Reference No: 6080

Location:

East London, Eastern Cape, ZA

Employment Type: Permanent

Disability (EE targeted role): No

T.A.S.K Grade: 12

Job Posting Salary: R579,259.00

Job Posting End Date: 26 Sep 2025

The Road Accident Fund's mission is to provide appropriate cover to all road users within the borders of South Africa; to rehabilitate and compensate persons injured as a result of motor vehicle accidents in a timely and caring manner; and to actively promote safe use of our roads.
SENIOR OFFICER: HOSPITAL CASE MANAGEMENT (X3) – TASK GRADE 12

Locations:

• East London (2 positions)
• Mthatha (1 position)

Purpose of the job: The Senior Officer: Hospital Case Management is responsible for the coordination of medical care for motor vehicle accident patients/claimants in Hospitals.

Key Performance Areas

Assessment of Injuries

• Assess extent of injuries on admitted patients.
• Daily assessment of patient according to prescribed measurements.
• Conduct daily patient scoring and data collecting.
• Monitor quality of care.
• Select and monitor clinical pathways.
• Identify patients' needs.
• Identify and record pre-existing conditions.

Facilitate patient care

• Facilitate multi-disciplinary patient care where appropriate.
• Facilitate timely transfers into the appropriate levels of care.
• Coordinate the admission and pre authorisations of the transfers.
• Coordinate and provide necessary health education.
• Discharge planning and vocational guidance for the afterlife changing event for client
• Drug utilization review.
• Proper handover to Field Case Management for continuation of care.

Patient advocacy

• Cost Benefits analysis of the medical services.
• Liaison between patient and care team to ensure common understanding and conflict resolution.
• Negotiate and procure resource services from providers.
• Ensure that patient confidentiality is maintained by all parties.

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 Hospital Case management reports.
• Recommend issuing of Undertaking Certificate.
• Provide a reasonableness report of patient care in preparation of the rehabilitation post discharge.

Stakeholder management

• 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 Professions or related qualification.
• Registration with the relevant Health Professional Council Body.

Experience

• Relevant 4 years' experience in the medical environment.
• Experience in Managed Healthcare.
• Knowledge of ICD and CPT coding will be an advantage.
• Valid code 8 driving license.

Technical and behavioural competencies required

Behavioural

• Planning Organising and Coordinating.
• Personal Mastery.
• Judgment and Decision Making.
• Ethics and Values.
• Client Service Orientation.

Technical

• Core specialities in the case management process.
• Knowledge of healthcare operations.
• Ability to maintain patient confidentiality.
• Full knowledge of medical tariffs, treatment plans.
• Coding standards and protocols.
• Knowledge of PFMA to be able to analyse different requirements as per the claimants.

NB: "RAF offers Total Employment Cost packages with no additional contributions from the Employer; successful candidates are required to structure their packages in a manner that will suit their needs."
The Road Accident Fund subscribes to the principles of employment equity and preference will be given to People with Disabilities.
Applicants who have not received any correspondence from us within six weeks from the closing date can consider themselves unsuccessful
Security Vetting shall be conducted on all prospective employees
It is the applicants' responsibility to have foreign qualification evaluated by the South African Qualification Authority (SAQA) and to provide proof of such evaluation.