Company:
Road Accident Fund
Industry: Government
Deadline: Not specified
Job Type: Full Time
Qualification: Bachelors
Experience:
Province: Limpopo, Mpumalanga
City:
Field: Medical / Healthcare
Key Performance Areas
Assessment of Injuries
- Assess extent of injuries on admitted patients.
- Daily assessment of patient according to prescribed measurements.
- Conduct daily patient scoring and data collecting.
- Monitor quality of care.
- Select and monitor clinical pathways.
- Identify patients’ needs.
- Identify and record pre-existing conditions.
Facilitate patient care
- Facilitate multi-disciplinary patient care where appropriate.
- Facilitate timely transfers into the appropriate levels of care.
- Coordinate the admission and pre authorisations of the transfers.
- Coordinate and provide necessary health education.
- Discharge planning and vocational guidance for the afterlife changing event for client
- Drug utilization review.
- Proper handover to Field Case Management for continuation of care.
Patient Advocacy
- Cost Benefits analysis of the medical services.
- Liaison between patient and care team to ensure common understanding and conflict resolution.
- Negotiate and procure resource services from providers.
- Ensure that patient confidentiality is maintained by all parties.
Facilitate the accuracy and effective submission of invoices
- Ensure that accounts submitted to the fund from service providers are valid in terms of RAF guidelines and the Road Accident Fund Act.
- Assess and monitor claims invoices to curb over servicing or abuse and fraudulent claims.
- Ensure that the accounts are paid timeously, according to service level agreements.
- Ensure that services and treatments claimed for are accident related (related to the accident under consideration).
- Compare outcomes and cost of different therapeutic modalities and surgical techniques and the information provided is invaluable in developing guidelines for clinical management.
Reporting
- Compile and update Hospital Case management reports.
- Recommend issuing of Undertaking Certificate.
- Provide a reasonableness report of patient care in prepation of the rehabilitation post discharge.
Stakeholder Management
- Communicate with all levels of stakeholders.
- Participate in relevant external RAF activities and events.
- Ongoing engagements with service providers.
Method of Application
Submit your CV and Application on Company Website:
