Fraud, Waste & Abuse Manager (Medical Aid) Pretoria

Cape Town - South Africa

Monthly Salary: Not Disclosed

Posted on: 30+ days ago

Vacancies: 1 Vacancy

Job Summary

Introduction

Fraud Waste & Abuse Manager (Medical Aid)

Location: Pretoria

Closing Date: 22 October 2025

Application Email: response at REF: MVG/FWA

We are recruiting for a newly created leadership role within a prominent healthcare organisations Legal Risk and Corporate Governance division. This is a strategic opportunity to shape and lead the organisations fraud waste and abuse (FWA) function with a mandate to safeguard financial integrity and uphold trust across member and provider engagements.

Key Responsibilities

Collaborate with executive leadership and legal counterparts to drive accountability and operational excellence.
Ensure compliance with regulatory frameworks and internal governance standards.
Lead the formation and management of the FWA department initially overseeing internal team members transitioning from the Claims division.
Develop and implement robust FWA prevention detection and investigation strategies across healthcare claims and provider interactions.

Reporting Structure

Reports directly to the Executive for Corporate Governance

Travel Requirements

Regional travel will occur typically monthly to quarterly.
National travel may be required on a quarterly basis.

Candidate Profile

Valid drivers license and own reliable vehicle.
Proven leadership experience within a Managed Care environment.
3 years experience in claims assessing.
At least 3 years experience within the Medical Aid Scheme industry.
Minimum 5 years experience managing large-scale fraud investigations.
Grade 12 and a relevant degree in Forensic Auditing Forensic Accounting Risk Management or related field.

Supporting Documents:

Copy of Certification (CFE)
Copy of Degree
Comprehensive CV detailing applicable FWA experience

This is a high-impact role for a seasoned professional ready to lead from the front and build a department that delivers measurable value.

To apply please email your CV to response at by 22 October 2025.

Required Experience:

Manager

IntroductionFraud Waste & Abuse Manager (Medical Aid)Location: PretoriaClosing Date: 22 October 2025Application Email: response at REF: MVG/FWAWe are recruiting for a newly created leadership role within a prominent healthcare organisations Legal Risk and Corporate Governance division. This is a st...