Medical Case Manager

ROLE SUMMARYWe are seeking a professional and experienced Medical Case Manager to join our team.
The purpose of this role is to provide medical expertise and contribute to the successful delivery of the company's services.
Responsibilities include hospital pre-authorization and claims, international patient case management and medical repatriations, and providing medical advice and counseling services.
If you are passionate about healthcare, possess strong administrative and communication skills, and thrive in a dynamic environment, we encourage you to apply.Must be able to work shifts (day and night).QUALIFICATIONSMinimum: Grade 12 or equivalent NQF level 4Minimum: Basic Life Support accreditation or equivalentEXPERIENCEMinimum of 2 years' experience in a similar roleCall center experience is advantageousMedical and insurance background is advantageousSKILLS & KNOWLEDGEStrong clinical backgroundExcellent telephonic and written communication skillsMultilingual abilitiesProficiency in Microsoft OfficeKnowledge of local medical aid, medical insurance, and international patient case management principlesUnderstanding of Short-Term Insurance principlesRESPONSIBILITIESProvide compassionate and friendly client care and guidanceCoordinate emergency medical services, including triage and ambulance dispatchManage GP, emergency room, and hospital pre-authorizationsFacilitate health advisory services according to protocolsCoordinate counseling services, including client intake, case registration, assignment, and follow-upManage international case management, medical repatriations, and mortal remains repatriationAdjudicate cases based on product benefits and conditionsMaintain detailed records of client interactions and treatment outcomesHandle logistics and stakeholder updates for mortal remains repatriationAnswer calls and perform administrative duties as requiredCOMPETENCIESShowing Composure: Remains calm under pressure and during critical eventsExamining Information: Analyzes information effectively and asks probing questionsConveying Self Confidence: Displays confidence and a positive outlookDocumenting Facts: Communicates clearly in writing and considers all relevant factsChecking Things: Ensures high-quality work with attention to detailProducing Output: Works efficiently under pressure and manages multitaskingManaging Tasks: Plans and organizes effectively, setting clear prioritiesArticulating Information: Communicates clearly and confidently in presentationsFollowing Procedures: Adheres strictly to rules and protocolsUnderstanding People: Listens well and understands others' feelings and motivations
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