Mediclinic Hospital Case Manager Jobs in South Africa

Mediclinic Hospital Case Manager Jobs in South Africa

Closing date: 31/12/2022

Number of positions: 1

Recruiter name: Linedhia Theunissen

Reference number: 30903

Permanent

Main Purpose of Job

To coordinate the hospital case management process and facilitate the communication process between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation.

Key Responsibility Areas

Minimise financial risk by effectively managing patient stay

Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems

Ensure correct and timeous finalisation of cases to facilitate reimbursements from funders of claims

Consistently and timeously communicate with Funders as contractually agreed through the relevant case management channels

Ensure clinical coding standards are adhered to as per Level 3 coding guideline

Lead and manage the people in the Case Management team (if applicable)

Required Education

Essential: Clinical qualification

Desired: Registered Nurse / Professional Nurse or qualified Paramedic

Required Experience

Essential Minimum: Minimum of 3 years in a clinical role

Desired: Experience in Theatre and or ICU; Medical aid background; Experience in private healthcare environment or experience as an ILS/ALS Paramedic

Required Job Skills and Knowledge

Anatomy; physiology and terminology

Funder Contracts; Medical aid requirements/narrations

Scientific nursing principles and process

B2B EMS (electronic message system: check

status of authorisations and use for trouble,shooting)

Computer literate (Microsoft Office)

Authorisation and motivation of Level of Care;

Length of Stay; Short Payments etc.

Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.)

Patient Administration policies and procedures (e.g. Patient Confidentiality;

Visitation of external case managers; etc.)

Daily workflow; managing deviances; coding; and case management processes

Application of clinical codes and finalisation thereof (Level 3 coding)

Patient admin programmes on the AS400 system

How to Apply

All applicants will be considered, with the
understanding that preference will be given in accordance with the Employment Equity Plan of Mediclinic Southern Africa, as well as internal applicants/employees that meet the minimum requirements.

For more information and job application details, see: Mediclinic Hospital Case Manager Jobs in South Africa

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