Introduction:

As a Medical Advisor, you will be reporting to the GM: Medical & Claims Management, you will be responsible for effective, prompt and correct assessment of claims and medical management of patients in terms of the various policies, administered by the Company.

Description:

THE JOB AT A GLANCE

As a Medical Advisor, you will be reporting to the GM: Medical & Claims Management, you will be responsible for effective, prompt and correct assessment of claims and medical management of patients in terms of the various policies, administered by the Company.

WHAT WILL YOU DO?

Provide specialist medical advice:

• Attend to medical related queries as received from the Claims Department


• Assess RMA’s liability for the condition and advise if the medical care is relevant and if what is being treated is forms part of the disease/occupational injury


• Perform Impairment Assessment in terms of the Compensation for Occupational Injuries and Diseases Act (includes the interpretation and provisions of the Act)


• Provide reports on Impairments Assessments / Disability percentage ratings


• Assess the fairness and relevance of medical invoices


• Assess is the liability of a claim that has been reopened sits with RMA


• Develop, review and maintain policies and procedures to assist the claims and medical departments with how to attend to issues

Stakeholder relationship management:

• Provide advice, medical and technical support to Claims and pensions staff, legal staff


• Assist and advise on RMA Pensioner Care in terms of COID Assist in the managed health care of RMA patients


• Build and maintain relationships with all stakeholders including Doctors and OMPs


• Provide staff training / training of prospective OMPs and other stakeholders (i.e. legal team, claims team, pensions) Assist PMCA’s with Clinics

Project participation and general administration:

• Assist and participate in special projects as and when required


• Attend conferences, seminars, workshops and maintain CDP points as part of continuous professional development


• Manage individual travel and accommodation budgets and assist with medical costs

WHAT YOU'LL BRING TO THE TABLE?

• MBChB


• Registration with appropriate Professional Body (Health Professions Council of South Africa and Medical Protection Society)


• Postgraduate Diploma in Occupational Health


• 5 – 7 years’ experience as occupational medical practitioner


• Work experience as mining medical officer (preferred)


• Proficiency in Microsoft office


• Principles of case management


• Compensation for Occupational Injuries and Diseases Act


• Occupational Diseases in Mines and Works Act


• Mine Health and Safety Act


• Occupational Health & Safety Act


• Labour Relations Act


• Road Accident Fund Act


• Principles of Managed Health Care


• Occupational Health Risk Management


• Analytical thinking


• Service Orientation / Customer Responsiveness


• Knowledge/Information Management


• Judgement and Decision-making


• Personal and professional development


• Stress handling


• Objectivity


• Self-Management

WHAT WILL YOU GET IN RETURN?

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

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 managers. Kindly note that should you not receive a response within 21 days please consider your application unsuccessful.

Closing date:

Our Commitment to transformation:

In accordance with the employment equity plan of Rand Mutual Assurance and its employment equity goals and targets, preference may be given, but is not limited, to candidates from under-represented designated groups.

Requirements:

WHAT YOU'LL BRING TO THE TABLE?

• MBChB


• Registration with appropriate Professional Body (Health Professions Council of South Africa and Medical Protection Society)


• Postgraduate Diploma in Occupational Health


• 5 – 7 years’ experience as occupational medical practitioner


• Work experience as mining medical officer (preferred)


• Proficiency in Microsoft office


• Principles of case management


• Compensation for Occupational Injuries and Diseases Act


• Occupational Diseases in Mines and Works Act


• Mine Health and Safety Act


• Occupational Health & Safety Act


• Labour Relations Act


• Road Accident Fund Act


• Principles of Managed Health Care


• Occupational Health Risk Management


• Analytical thinking


• Service Orientation / Customer Responsiveness


• Knowledge/Information Management


• Judgement and Decision-making


• Personal and professional development


• Stress handling


• Objectivity


• Self-Management