Medical Aid Industry
Duties include but not limited to:
To lead, 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.
Minimum Requirements:
Grade 12
Degree in Forensic Auditing, Forensic Accounting, Risk Management or related fields
Five – Seven years of experience in fraud management/investigations
Five years of experience managing large scale investigations
Three years’ experience in a Medical Aid Scheme industry
Three years claims assessing experience
Valid Driver’s licence and own reliable vehicle
Salary is commensurate with experience level.
Please send your updated CV to target='_blank
Closing date – 02/09/2025
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