Manager: Field Case Management

22/05/2025 admin RAF JOBS 0

Manager: Field Case Management – Groote Schuur / Tygerberg Hospital | Road Accident Fund

Division: 3300
Reference Number: 5687
Location: Cape Town, Western Cape, South Africa
Employment Type: Permanent
T.A.S.K Grade: 16
EE Targeted Role: No
Salary: R1,028,791.00 per annum
Closing Date: 27 May 2025

About the Road Accident Fund (RAF)

The Road Accident Fund (RAF) is a vital South African government entity mandated to provide appropriate cover to all road users within the borders of South Africa. The organization is committed to rehabilitating and compensating individuals injured in road traffic accidents in a manner that is timely, caring, and responsive. With an emphasis on client-centric service delivery and public safety, RAF continually enhances its systems to ensure meaningful recovery and reintegration for claimants.

Purpose of the Role

The primary objective of the Manager: Field Case Management is to lead and coordinate comprehensive case management services that effectively address the rehabilitation and healthcare needs of injured individuals. Based at Groote Schuur or Tygerberg Hospital in Cape Town, this role oversees the assessment, planning, implementation, and evaluation of care management plans aimed at optimal patient recovery.

Key Responsibilities

Policy Implementation and Strategic Alignment

  • Contribute to the enhancement of the national case management strategy

  • Stay updated on best practices in clinical case management and healthcare delivery

  • Align field operations with both short-term rehabilitation goals and long-term recovery outcomes

Comprehensive Case Management

  • Supervise the full lifecycle of assigned cases

  • Manage the appointment and training of caregivers

  • Ensure cost-effective and high-quality care delivery

  • Conduct multidisciplinary case reviews and present complex cases at conferences

  • Ensure accurate compliance reporting for claimant care

Rehabilitation Oversight

  • Monitor claimants’ progress through personalized rehabilitation plans

  • Assess medical conditions and ensure services are suitable for the level of care required

  • Supervise in-home assessments and gap identification in care delivery

  • Guide family members on support systems and recovery expectations

  • Appoint and manage service providers in line with contract protocols

Work and Community Reintegration

  • Facilitate return-to-work programs through employer and physician coordination

  • Recommend duty modifications based on claimant limitations

  • Connect claimants with relevant community resources for social integration

Invoice Validation and Compliance

  • Validate healthcare invoices against actual services provided

  • Prevent fraudulent billing through strict monitoring procedures

  • Ensure all payments comply with RAF Act and related healthcare guidelines

Detailed Reporting

  • Compile rehabilitation progress and cost analysis reports

  • Submit monthly and quarterly case management evaluations

  • Report on return-to-work prospects and overall claimant health improvements

  • Monitor alignment of expenditures with budgeted certificate allocations

Stakeholder Engagement

  • Build strong relationships with healthcare professionals and service providers

  • Ensure effective referral and feedback mechanisms

  • Resolve disputes and provide clear communication to stakeholders

People Leadership and Team Management

  • Lead a high-performing operations team

  • Drive employment equity objectives and recruit accordingly

  • Implement human capital practices to address internal challenges

  • Motivate and guide team members toward performance excellence

Qualifications and Experience

  • Bachelor’s or Advanced Diploma in a health science or medical-related field

  • Postgraduate qualification in Health Sciences (advantageous)

  • Registered with a recognized Health Professional Body

  • 6 to 8 years of experience in nursing or clinical case management

  • Minimum 2 years in a supervisory or management position

Core Competencies Required

Behavioral

  • Ethical decision-making

  • Excellent communication

  • Stakeholder collaboration

  • Resilience and adaptability

  • Service orientation

Managerial

  • Project and risk management

  • Strategic leadership

  • Coaching and mentoring

  • Change management and conflict resolution

Technical

  • Proficiency in ICD/CPT coding

  • Medical bill auditing

  • In-depth knowledge of healthcare systems

  • Understanding of Motor Vehicle Accident legislation

  • Familiarity with Public Finance Management Act

Why Join the Road Accident Fund

Working at RAF offers professionals an opportunity to contribute meaningfully to the lives of road accident victims. Employees benefit from a Total Employment Cost (TEC) package, structured to suit individual financial planning. RAF is a champion of employment equity, with a strong focus on supporting persons with disabilities.

How to Apply

To apply, candidates should prepare a detailed CV and supporting documentation and submit their application through the official RAF recruitment portal before the closing date: 27 May 2025.

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