Fraud, Waste and Abuse Manager
16 hours ago
A Medical Aid based in Pretoria is seeking a Fraud, Abuse and Waste Manager to join their Corporate Governance team.
Job Purpose:
- Manage, and enhance the organisation's fraud, waste, and abuse prevention, detection, and investigation efforts across all healthcare-related claims and provider engagements.
- Responsible for developing, implementing, and overseeing strategies to prevent, detect, investigate, and mitigate fraudulent, wasteful, and abusive activities for the Scheme.
- The role ensures compliance with regulatory requirements, protects the Scheme's financial integrity, and safeguards member and provider trust.
Requirements:
- Grade 12
- Degree in Forensic Auditing, Forensic Accounting or Risk Management
- 5 years of experience in managing large scale investigations within Fraud Management
- 3 years experience in a Medical Aid Scheme Industry
- 3 years Claims assessing experience
- Valid Drivers license and own reliable vehicle
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