6 Medical Consultant jobs in South Africa

Division: Claims

Reference No: 6068

Location:

Johannesburg, Gauteng, ZA

Employment Type: Fixed Term Contract

Disability (EE targeted role): No

T.A.S.K Grade: 11

Job Posting Salary: R501,775.00

Job Posting End Date: 28 Oct 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.
NB: This is a Three (3) years Fixed-Term Contract position
Purpose of the job:
The
Consultant: Medical Management
is responsible to implement the medical management activities, medical exception handling and providing administration support in claims processing.

Key Performance Areas
Medical Management.

• Conduct medical assessment and compile injury assessment reports.
• Conduct assessments and bill reviews on submitted claims, focusing on the appropriate level of care, the length of stay, and quality of care.
• Incorporate tariffs, cost savings initiative recording, and treatment protocol to ensure that all service providers adhere to the rules, and the tariff as guided by the RAF and / or any that is considered reasonable.
• Pre authorise submitted claims aligned to RAF clinical guidelines including the RAF formularory, treatment protocols and related tarrifs.
• Escalation of complex cases for multi disciplinary review and adjudication.
• Participate in the consultations process on the implementation of medical claims processes.

Exception Handling.

• Ensure the implementation and maintenance of a formal exception handling process within the medical management.
• Maintain the documentation and regular updating of the exception handling process.
• Maintain the implementation an unusual occurrence procedures.

Reporting.

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.
• Produce documents, briefing papers, reports and presentations.

Stakeholder Management

• Deal with/and respond to correspondence.
• Maintain healthy relationships with all stakeholders.
• Follow up and resolve all queries, following up and making recommendations on which corrective actions are appropriate.
• Follow up and feedback to all stakeholders to keep them updated on the status of a query.
• Respond to queries within the predefined turnaround times.

Qualifications

• Bachelor's Degree/Advanced Diploma in Health Sciences /Medical related qualification.
• Registration with HPCSA/SANCA.

Experience

• Relevant 3 years' experience in a Medical related environment.

Technical And Behavioral Competencies Required

• Claims management process/ processes and systems.
• Medical product management
• Medical bill reviewing
• Medical case management
• Complex problem identification, solving and decision making
• Customer value proposition
• Strong clinical analytical capabilities
• Knowledge of motor vehicle accident legislation
• Planning, Organising and Coordinating
• Personal Mastery
• Judgement and Decision Making
• Ethics and Values
• Client Service Orientation

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: Operations

Reference No: 5996

Location:

Durban, Kwazulu-Natal, ZA

Employment Type: Fixed Term Contract

Disability (EE targeted role): Yes

T.A.S.K Grade: 11

Job Posting Salary: R501,775.00

Job Posting End Date: 15 Oct 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 Consultant: Medical Management is responsible to implement the medical management activities, medical exception handling and providing administration support in claims processing.

NB: This is a 3 Years Fixed Term Contract.
Key Performance Areas
Medical management.

• Conduct medical assessment and compile injury assessment reports.
• Conduct assessments and bill reviews on submitted claims, focusing on the appropriate level of care, the length of stay, and quality of care.
• Incorporate tariffs, cost savings initiative recording, and treatment protocol to ensure that all service providers adhere to the rules, and the tariff as guided by the RAF and / or any that is considered reasonable.
• Preauthorize submitted claims aligned to RAF clinical guidelines including the RAF formularory, treatment protocols and related tariffs.
• Escalation of complex cases for multi-disciplinary review and adjudication.
• Participate in the consultations process on the implementation of medical claims processes.

Exception handling

• Ensure the implementation and maintenance of a formal exception handling process within the medical management.
• Maintain the documentation and regular updating of the exception handling process.
• Maintain the implementation of an unusual occurrence procedure.

Reporting.

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad hoc reports on process improvement initiatives.
• Produce documents, briefing papers, reports and presentations.

Stakeholder management.

• Deal with/and respond to correspondence.
• Maintain healthy relationships with all stakeholders.
• Follow up and resolve all queries, following up and making recommendations on which corrective actions are appropriate.
• Follow up and feedback to all stakeholders to keep them updated on the status of a query.
• Respond to queries within the predefined turnaround times.

Qualifications And Experience

• Bachelor's Degree/Advanced Diploma in Health Sciences /Medical related qualification.
• Registration with HPCSA/SANCA.
• Relevant 3 years' experience in a Medical related environment.

Behavioral competencies

• Planning, organization and coordinating.
• Personal mastery.
• Judgement and Decision Making
• Ethics and values.
• Client service orientation

Technical competencies

• Claims management process/ processes and systems
• Medical product management
• Medical bill reviewing
• Medical case management
• Complex problem identification, solving and decision making
• Customer value proposition
• Strong clinical analytical capabilities
• Knowledge of motor vehicle accident legislation

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: Operations

Reference No: 5908

Location:

Menlo Park, Gauteng, ZA

Employment Type: Fixed Term Contract

Disability (EE targeted role): No

T.A.S.K Grade: 11

Job Posting Salary: R501,775.00

Job Posting End Date: 16 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.
Note: THIS IS A THREE (3) YEAR FIXED TERM CONTRACT
Purpose of the Job:
The
Consultant: Medical Management
is responsible to implement the medical management activities, medical exception handling and providing administration support in claims processing.

Key Performance Areas
Medical Management

• Conduct medical assessment and compile injury assessment reports.
• Conduct assessments and bill reviews on submitted claims, focusing on the appropriate level of care, the length of stay and quality of care.
• Incorporate tariffs, cost savings initiative recording and treatment protocol to ensure that all service providers adhere to the rules and the tariff as guided by the RAF and/or any that is considered reasonable.
• Pre-authorise submitted claims aligned to RAF clinical guidelines including the RAF formulary treatment protocols and related tariffs.
• Escalation of complex cases for multi-disciplinary review and adjudication.
• Participate in the consultations process on the implementation of medical claims processes.

Exception Handling

• Ensure the implementation and maintenance of a formal exception handling process within the medical management.
• Maintain the documentation and regular updating of the exception handling process.
• Maintain the implementation an unusual occurrence procedures.

Reporting

• Track and report against set objectives and targets.
• Report on emerging risks.
• Provide ad-hoc reports on process improvement initiatives.
• Produce documents, briefing papers, reports and presentations.

Stakeholder Management

• Deal with/and respond to correspondence.
• Maintain healthy relationships with all stakeholders.
• Follow up and making recommendations on which corrective actions are appropriate.
• Follow up and feedback to all stakeholders to keep them updated on the status of a query.
• Respond to queries within the predefined turnaround times.

Qualifications And Experience

• Bachelor's Degree/Advanced Diploma in Health Sciences/Medical related qualification.
• Registration with HPCSA/SANCA.
• Relevant 3 years' experience in A Medical related environment.

Technical Competencies Required

• Claims management process/processes and systems.
• Medical product management.
• Medical bill reviewing
• Medical case management

Behavioural Competencies Required

• Planning, Organising and Coordinating
• Personal mastery
• Judgment and decision making
• Ethics and Values
• Client Service Orientation

NB: "RAF offers Total Employment Cost packages with no additional contributions from the Employer, successful candidates are required to structure their packages in a manner that will suit their needs".
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.

Retail Frontline Consultant – Medical Industry

Location: Across South Africa (25 established retail branches)

Remuneration: R10 000 basic salary + performance-based commission

Position Summary

We are looking for a customer-focused and results-oriented professional to become part of our growing national retail network. This position blends sales performance, client interaction, administrative support, and basic technical assistance — with full training provided.

Main Duties & Responsibilities

• Oversee the reception area, welcoming and assisting walk-in customers
• Promote products and services while achieving monthly sales objectives
• Conduct light technical and product-related tasks as per training guidelines
• Represent the brand during scheduled mall and promotional events
• Maintain accurate records and support day-to-day retail operations

Desired Candidate Profile

• Neat, professional appearance with strong communication and interpersonal skills
• Proficient in English and Afrikaans (spoken and written)
• Prior experience in retail, telesales, call centres, or direct sales will be advantageous
• Confident working towards targets and delivering measurable results
• Computer literate with reliable transport or valid driver's licence

We Offer

• A competitive starting salary of R10 000 per month
• Performance-based commission and incentives aligned with store results
• Training and development opportunities within a national retail group
• Clear pathways for career progression and long-term growth

If you're a motivated professional who thrives in a people-focused, sales-driven environment, we'd love to hear from you.

Job Type: Full-time

Pay: From R10 000,00 per month

Work Location: In person

Company Description

iMbewu Financial Services (Pty) Ltd is a Level 1 BBBEE contributor. We assist employers with the development and maintenance of employee benefits packages and other financial services offerings in South Africa and across Africa. Our dedicated team strives to provide comprehensive financial solutions tailored to the needs of each client. We focus on enhancing the financial well-being of employees through effective benefits management.

Role Description

This is a full-time role located in the Gauteng, for a Medical Aid Advisor/Healthcare Consultant. The Medical Advisor/Healthcare Consultant will be responsible for providing expert advice on medical aid and gap cover options, assisting clients with selecting appropriate medical benefits, and offering support for any medical scheme-related inquiries. Daily tasks will include:

• Providing expert advice to members selecting medical scheme and gap cover options.
• Providing members with medical scheme benefit comparisons.
• Assist members with medical scheme related queries.
• Conduct medical scheme related presentations.
• Assist employer contacts with billing related services

Qualifications

• Knowledge of Medical Scheme Act and medical schemes in South Africa
• Experience in providing medical scheme and gap cover advice
• Skills in presenting and drafting of presentations
• Excellent communication and interpersonal skills
• Ability to work collaboratively in a team environment
• RE 5
• 120 FAIS Credits
• Drivers Licence