Case Manager – Registered Nurse – Hospital Group – White River, Mpumalanga Full Time

About the Job:

Our Client is seeking an experienced and compassionate Registered Nurse Case Manager to join its multidisciplinary healthcare team

The successful candidate will be responsible for coordinating clients’ treatment journeys, managing medical-aid authorisations, maintaining accurate clinical documentation and ensuring continuity of care from admission through to discharge and aftercare

Requirements:

• Registered Nurse qualification
• Current registration with the South African Nursing Council (SANC)
• Case management experience within a healthcare environment
• Comprehensive working knowledge of ICD-10 coding is essential
• Candidates must be able to accurately interpret, select and apply relevant ICD-10 diagnostic codes
• Experience with medical-aid authorisations, clinical motivations and treatment extensions
• Experience within private healthcare, psychiatric care, mental health, addiction treatment or rehabilitation will be advantageous
• Sound knowledge of medical-aid rules, clinical documentation and healthcare legislation
• Proficiency in Microsoft Office and electronic clinical-record systems
• A valid driver’s licence will be advantageous
• Strong clinical-assessment and case-management skills
• Strong medical-aid liaison and authorisation skills
• Excellent written and verbal communication
• Strong report-writing and record-keeping abilities
• High attention to detail and accuracy
• Compassionate and professional approach to client care
• Ability to manage sensitive and complex cases
• Strong planning, organisational and time-management skills
• Ability to work effectively within a multidisciplinary team

Duties & Responsibilities:

• Coordinate and manage clients’ treatment plans from admission to discharge
• Conduct initial and ongoing clinical assessments
• Develop individualised case-management plans in collaboration with the multidisciplinary team
• Monitor clients’ progress and regularly review treatment goals
• Liaise with medical aids, funders and external healthcare providers
• Obtain and manage treatment authorisations and extensions
• Compile detailed clinical motivations and progress reports
• Accurately apply and verify ICD-10 diagnostic codes
• Ensure that all clinical documentation and coding comply with medical-aid and legislative requirements
• Facilitate communication between clients, families, healthcare professionals and relevant stakeholders
• Participate in multidisciplinary team meetings and clinical case discussions
• Coordinate referrals, transfers, follow-up appointments and aftercare arrangements
• Identify clinical, psychosocial and operational risks and escalate concerns appropriately
• Maintain strict confidentiality and comply with all professional and healthcare standards

Should you meet the above requirements, we urge you to apply by forwarding your CV along with any supporting documents to tracy@glass-house.co.za