Case Manager (Hospital Group) – Lenasia

The Case Manager will be the liaison between the patient and medical aids in order to secure payment for the hospital

 

Inherent Requirements:

  • B Degree Nursing qualification or equivalent NQF level 6
  • 3 years patient care experience
  • Previous ICU / HC case management experience will be advantage
  • Understanding of clinical coding, funder rules nursing policies and procedures
  • Nursing policies and procedures
  • SAP experience preferably
  • Must be available to work overtime where required
  • Advanced computer literacy will be an advantage
  • Good communication skills
  • Good customer responsiveness
  • Good time management skills
  • Need to work under pressure

 

Duties & Responsibilities:

  • Ensuring operational excellence
  • By conducting ward rounds and ensuring the accurate, complete collection of clinical data from the patient files
  • Liaising between nursing staff and attending clinicians
  • Updating accurate clinical information to justify length of stay and level if care to medical schemes of specialised unit cases and where operationally required general ward cases
  • Updating and providing the information to funders regarding high value items, limited benefits and protocols as defined by managed care organisations
  • Communicating funder requirements / responses to attending clinicians and patients where necessary compliance with industry standards
  • Ensuring effective management of real time messaging, including requests, responses, rejections and submissions
  • Ensuring the accurate submission of accounts to funders
  • Complying with governance and risk management requirements by ensuring to patient services policies and procedures
  • Ensuring correct application of ARM agreements on patient accounts
  • Ensuring the accurate and complete coding of patient accounts
  • Building and maintaining relationships with internal stakeholders

 

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

Candidates are welcome to apply via Pnet using this link : Pnet – Case Manager (Lenasia, JHB)

Should you know of anyone who might be interested in applying for this position, you can share this post with them using this link : GHR – Case Manager (Lenasia, JHB)

 

Should you not hear from a recruiter within two to three workings days, kindly consider your application unsuccessful.

While we aim to communicate with each candidate, be their application successful or note, it is often possible that we might’ve overlooked your application – in this case; you are welcome to follow up by emailing the provided email address regarding progress on your application – you are also welcome to contact our office on 021 554 5309

Only candidates can apply for this job.
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17 Waterville St,
Sunningdale,
Cape Town
info@glasshouserecruiting.co.za
+27 21 554 5309 / +27 21 200 6629