Hospital Case Manager

Choose how often (in days) you want to receive a notification:Closing date: 15/05/2025Number of positions: 1Recruiter name: Daniel Gert Andries Van Der WesthuizenReference number: 60138Workplace Type: On-siteEmployment type: PermanentPlease note: If you are an internal employee on a fixed-term contract, please apply using an external candidate profile and not your employee profile.MAIN PURPOSE OF THE JOBTo coordinate the hospital case management process and facilitate communication between all role players by providing accurate and timely clinical information to minimise the financial risk for the organisation.KEY RESPONSIBILITY AREASMinimise financial risk by effectively managing patient staysEnsure compliance with case management procedures, contracts, and legal requirements by utilising available resources and systemsEnsure correct and timely finalisation of cases to facilitate reimbursements from fundersCommunicate consistently and promptly with funders as per contractual agreements through the relevant channelsEnsure adherence to clinical coding standards as per Level 3 coding guidelinesLead and manage the Case Management team (if applicable)REQUIRED EDUCATIONDesired Education: Registered Nurse / Professional Nurse or qualified ParamedicREQUIRED EXPERIENCEEssential Minimum Experience: Minimum of 3 years in a clinical roleDesired Experience: Experience in Theatre and/or ICU; Medical aid background; Experience in private healthcare or as an ILS/ALS ParamedicREQUIRED JOB SKILLS AND KNOWLEDGEAnatomy (including terminology)Funder Contracts; Medical aid requirements/narrationsPatient admin programmes on the AS400 systemScientific nursing principles and processesAuthorisation and motivation of Level of Care; Length of Stay; Short Payments, etc.Relevant statutory acts (e.g., Consumer Protection Act; PMB; etc.
)Patient Administration policies and procedures (e.g., Confidentiality; Visitation policies)Daily workflow management; managing deviations; coding; and case management processesApplication of clinical codes and finalisation (Level 3 coding)All applicants will be considered, with preference given in accordance with the Employment Equity Plan of Mediclinic Southern Africa, including internal applicants/employees meeting the minimum requirements.Note: Internal employees on fixed-term contracts should apply using an external candidate profile.Become part of our Talent Community; we will contact you when a relevant opportunity matching your skills, interests, and experience arises.
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