Pensions Medical Case Assessor 4 Months Contract

2 weeks ago


Parktown, South Africa Rand Mutual Assurance Full time

**THE JOB AT A GLANCE**

As the Pensions Medical Case Assessor (PMCA), you will be responsible for effectively and efficiently rendering medical support to internal and external stakeholders.

**WHAT WILL YOU DO?**
- Monitoring of Hospital Admissions weekly and liaison with Case Managers.
- Give feedback to Case Managers and other Colleagues of Pensioners admitted in Hospitals and include for hospital utilisation management.
- Authorization of Pensioners Hospital admissions, Chronic Medications and Sundries, prosthetic repairs and replacement
- Adjudicate requests for subsequent care and refer to RMA doctor as necessary.
- Assess and adjudicate medical service provider reports and advise on invoices submitted and captured when requested.
- Visit medical service providers and hospitals to address Pensioners related issues
- Organize and attend scheduled clinics.
- Organize transport for SCI acute admissions, uro reviews and taxi fares for prosthetic pensioners.
- Visit existing high risk/cost and new DRG 1 pensioners as per PMP schedule.
- Organizing uro reviews and capture the uro report.
- Organize prosthetic review clinic and load report on CC2.
- Assist to obtain death certificate and Notification of Death (if available) for deceased pensioners and autopsy reports if available.
- Assist with medical walk-in office clients.
- Capture Medical Reports via scanning in respect of pensioners, chronic medication, and subsequent care and specific medical reports requested.
- Assist with education of pensioners on entitlements.
- Updating DOCR with hospital pensioner admissions and discharges for DRG 1 to 3.
- Weekly/Monthly report of Pensioner URO reviews, home visits and prosthetic reviews and other interventions.
- Manage visa and passport expiry documents of SCI pensioners in Hospital.
- Managing and control of medical expenses as per yearly plan
- Follow up, from RMA system generated reports, high cost claims based on type of injury and estimated costs.

**WHAT YOU'LL BRING TO THE TABLE?**
- Nursing diploma /degree
- 3 years nursing experience as professional nurse
- Valid Driver’s License
- Registration with Nursing Council or relevant Health Professional Council
- Building Customer Loyalty
- Contributing to Team Success
- Managing Work (includes Time Management)
- Stress Tolerance
- Decision Making
- Confidentiality
- Credibility
- Friendly
- Initiative
- Integrity

**WHAT WILL YOU GET IN RETURN?**

This is an exciting opportunity within the Rand Mutual Assurance team, offering exposure to an interesting combination of technical and business issues. This is a great time to join RMA as we look to grow the Life business and develop our actuarial team.

We offer great opportunities for personal and professional development in a stable company that’s 128 years strong. The role comes with a competitive salary package and various benefits. Flexible work arrangements (combination of remote and in the office). Furthermore, you will be a part of a dedicated group of colleagues who value teamwork and collaboration.

**Turnaround time**

**Closing date**:
**Our Commitment to transformation**:

- Nursing diploma /degree
- 3 years nursing experience as professional nurse
- Valid Driver’s License
- Registration with Nursing Council or relevant Health Professional Council
- Attention to detail
- Building Customer Loyalty
- Contributing to Team Success
- Managing Work (includes Time Management)
- Stress Tolerance
- Decision Making
- Confidentiality
- Credibility
- Friendly
- Initiative
- Integrity


  • Hum Assessor

    4 weeks ago


    Parktown, South Africa Rand Mutual Assurance Full time

    **THE JOB AT A GLANCE** As the HUM Assessor, you will effectively and efficiently process pre-authorisations for in-patient treatment for Compensation for Occupational Injuries and Diseases Act (COIDA) accidents. **WHAT WILL YOU DO?** - Develop, Generate the preauthorisation and feedback to Medical Service Provider (MSP) timeously. - Generate the hospital...


  • Parktown, South Africa AJ Personnel Full time

    **Main purpose of the job**: - To provide administrative support to the Human Resources team and assist with a wide range of Human Resources related activities and tasks **Location**: - **Parktown - Johannesburg** **Key performance areas**: - Compile contract renewals, transfer/increase/promotion/retirement/change in working conditions letters,...

  • Contracts Intern

    1 month ago


    Parktown, South Africa AJ Personnel Full time

    **Main purpose of the job**: - This position will suit a dynamic and self-motivated individual with excellent organizational skills, good writing skills, and good interpersonal communication skills - The main role is to be a liaison between WHC (legal and HR) and the SBIMB Projects Office **Location**: - **Sydney Brenner Institute for Molecular Bioscience...


  • Parktown, South Africa Hollard Recruitment Full time

    **Job Advert Summary**: Helloan exciting new opportunity has just become available in our **Insure, Operations area.** We are looking to recruit a **Marsh Claims Consultant** **Role Objectives**: Manage Motor and Non Motor claims received from Marsh Insurance Brokers Countrywide, as per the Marsh SLA, and in line with the Hollard Mandate. Ensure strong...

  • Legal Officer

    1 month ago


    Parktown, South Africa Talent 101 Full time

    Responsible for assisting with monitoring and/or advising on all legal matters, commercial contracts, and agreements. - **LLB / B-Com Law with Minimum 2 years’ experience**: - **Labour Legislation**: - **Sound knowledge of applicable HC legislation: LRA, EEA, BCEA, SDA** Valid SA Drivers’ License - Assist with Drafting a wide variety of legal...


  • Parktown, South Africa HCV Full time

    HCV, an insurance underwriting company in Parktown, Johannesburg has a vacancy for a Junior Claims Technician. The company specialises in Heavy Commercial Vehicles Underwriting, with a focus on the SME market. The company has been in operation for about 30 years and has a good track record in the industry. **Key Responsibilities**: - Efficiently register...

  • Medical Receptionist

    4 weeks ago


    Parktown, South Africa Afrizan People Intelligence Full time

    **JOB DESCRIPTION** **A client in the Pharmaceuticals industry is looking for an enthusiastic and experienced Receptionist.** **Job Requirements** - Switchboard - Responsible for accurate recording of messages and forwarding messages electronically to the relevant persons - Strong communication skills with the ability to discuss any issues with a wide...

  • Clinical Trainer

    1 month ago


    Parktown, South Africa AJ Personnel Full time

    **Main purpose of the job**: - To provide training and ongoing support to clinical staff at healthcare facilities to ensure the successful implementation of the TB and HIV Viral Load acceleration plan in South Africa **Location**: - **WDIH - Parktown, Johannesburg** **Key performance areas**: - Conduct a needs assessment - Research relevant topics to be...


  • Parktown, South Africa AJ Personnel Full time

    **Main purpose of the job**: - Lead the drug development and regulatory processes workstream for the market-shaping output **Location**: - **Parktown - Johannesburg** **Key performance areas**: - Lead the drug development & regulatory processes workstream - Work closely with CHAI and lead product development, regulatory, and quality assurance...


  • Parktown, South Africa AJ Personnel Full time

    **Main purpose of the job**: - To oversee all data management aspects of the core SAPRIN protocol implementation, as well as of other smaller research projects, including documentation, timelines, and staff oversight to ensure data integrity, and provide analytic output - Also to engage with data science groups at all partner institutions **Location**: -...


  • Parktown, South Africa AJ Personnel Full time

    **Main purpose of the job**: - Assume overall direct responsibility for the deliverable of the Market Shaping output, manage all milestones, timelines, and any emerging interdependencies - Lead the implementation of the Market Shaping working **Location**: - **Parktown - Johannesburg** **Key performance areas**: - Provide overall project leadership of...

  • Legal Secretary

    4 weeks ago


    Parktown, South Africa Rand Mutual Assurance Full time

    **THE JOB AT A GLANCE** As the Legal Secretary you will be reporting to the Head: Operational Legal. You will be responsible for providing administrative support to the Legal Service Department and other business Units. **WHAT WILL YOU DO?** - Setting up Tribunal hearings for adjudication of claims. - Prepare tribunal hearings including but not limited to...

  • Bee Coordinator

    4 weeks ago


    Parktown, South Africa Rand Mutual Assurance Full time

    As the BEE Coordinator you will be responsible for providing administrative support for the BEE function including the monitoring and tracking of the BEE Scorecard and Licence with the CF, tracking the execution of projects and initiatives by the business and ensuring that business is educated on the requirements and processes around BEE. **WHAT WILL YOU...


  • Parktown, South Africa AJ Personnel Full time

    Main purpose of the job: Assume overall direct responsibility for the deliverable of the Market Shaping output, manage all milestones, timelines, and any emerging interdependencies Lead the implementation of the Market Shaping working Location: Parktown – Johannesburg Key performance areas: Provide overall project leadership of market surveillance...

  • Technical Trainer

    1 month ago


    Parktown, South Africa AJ Personnel Full time

    **Main purpose of the job**: - Assist in ensuring that HIV viral load testing and EID program is aligned to national ART guidelines, thus ensuring a well-coordinated and functional HIV viral load and EID testing program **Location**: - **WDIH - Parktown, Johannesburg** **Key performance areas**: - Ensure facilities have all applicable handbooks, all...


  • Parktown, South Africa The Aurum Institute Full time

    **Occupational Health Nurse** The assessment of illnesses and injuries to ensure optimal functioning of occupational health care and primary health care services for Aurum Innova in accordance with Aurum Innova health policies and procedures and Occupational Health and Safety Act. **Technical Work Responsibilities** - Perform and follow-up of...


  • Parktown, South Africa AJ Personnel Full time

    Main purpose of the job: Project manage and support the drug development and regulatory processes workstream of the market shaping output Location: Parktown – Johannesburg Key performance areas: Project manage and support the drug development and regulatory processes workstream Together with the senior technical specialist, work closely with CHAI and...


  • Parktown, South Africa Rand Mutual Assurance Full time

    **THE JOB AT A GLANCE** As the Senior Associate: Investments & Corporate Finance, you will be participating in developing investment recommendations for portfolio manages relating to existing and potential investments, through developing and amending quantitative models to analyze and forecast market developments, estimating risks, identifying factors...


  • Parktown, South Africa iOCO Full time

    JOBNUMBER **iOCO03056** - CONTRACT TYPE **Contract** - STATE/PROVINCE **Gauteng** - CONTRACT TYPE: **OnSite** **The Role**: **Skills and Experience**: **What you’ll do**: - Maintenance of staff computers and printers and general user support. - Monitor problem ticket work queues and interact with management to provide progress updates and closure...

  • Underwriter

    1 month ago


    Parktown, South Africa Hollard Recruitment Full time

    **Job Advert Summary**: Hello an exciting new opportunity has just become available in our Hollard International, Hollard Health Underwriting area. We are looking to recruit an Underwriter (Permanent). As Hollard Health, we are passionate about Africa and we believe that the most powerful way to create a better future for the continent, is to improve the...