Key Performance Areas

Provide Leadership in the Claims Assurance Management

• Manage, monitor and ensure that claims assurance is effectively conducted and finalised in accordance with defined processes and procedures.
• Ensure all claims assurance requests are reviewed in a timely and correct manner.
• Ensure that complete diary notes are made on the Claims Assurance Management System daily.
• Ensure that proper records and systems are in place for all claims assurance requests received.
• Ensure that all claims assurance data (information and statistics) is captured into a database.
• Manage the collation of statistical and narrative reports on claims assurance caseload, progress, findings and recommendations for process improvements.
• Liaise with stakeholders, e.g. medical and other experts where applicable

Provide Legal Advice

• Provide legal advice to the RAF on litigated claims and direct claims as and when required.
• Ensure that deviation from policy or process on claims is documented, reported and remediated.
• Ensure the implementation of training initiatives that optimise claims processing within the claims assurance department.

Policy Review and Implementation

• Contribute to the development and implementation of RAF policies, procedures and processes.
• Contribute to the development of Combined Assurance Framework, policies, procedures and guidelines; and guide the process through the alignment of the documents to the overall RAF’s Strategy.
• Keep up to date with effective policy and practice execution strategies.

Reporting

• Prepare regulation reports as and when required to provide progress, updates, make recommendations to inform management decisions.
• Develop functional reporting systems, for management, projects or performance reporting.
• Prepare proposals, briefings, presentations, reports, and other documentation and provide management information both verbally and in writting.

Stakeholder Management

• Support relationship building with internal and external stakeholders to facilitate performance of assurance engagements and exchange of knowledge on assurance best practice.
• Build relationship with internal and external stakeholders to facilitate performance of assurance engagements and identify appropriate areas of management support.
• Mantain relationships with vendors, service providers or procurement teams and ensure that all relevant procured items are invoiced and paid on time.
• Advise management on effective control measures, systems and fraud prevention measures.
• Represent the Fund in relevant external activities and events.

People Management

• Ensure the sourcing, development and retention of a high-performance team.
• Manage staff in the department to ensure that they achieve their objectives in line with the strategic objectives of the RAF.
• Manage the implementation of human capital processes and procedures to control/ regulate workplace conflict and/or institute corrective measures and consultation processes to address deviations from standards.
• Ensure capacity development of staff and identify appropriate developmental opportunities.
• Manage performance of staff, mentor and couch staff.

Qualifications and Experience

• Bachelor’s degree in law or equivalent.
• Postgraduate in Law related qualification will be an added advantage.
• Qualification in legislative drafting advantageous
• Relevant 6 – 8 years’ experience within the Litigation environment of which 2 years must have been on a supervisory level/ management level/ area of expertise
• Business sector experience, preferably in a parastatal organisation would be advantageous
• Experience in a Legal Services field