Case Manager

2 weeks ago


Pretoria, Gauteng, South Africa HRInsync Full time

Case Manager

About
One of the largest private Medical Aid companies in SA. They have been established for 20 years and are striving to be #1 in SA.

Purpose
Delivering of cost-effective managed healthcare service to accomplish member satisfaction

Duties and responsibilities
Delivering of cost-effective managed healthcare service to accomplish member satisfaction.

  • Case management of authorised cases according to the acceptable Scheme rules and protocols.
  • To reduce the risk associated with hospitalization and to provide an effective and unique managed healthcare
  • To assist the member by approving appropriate funding.
  • To deliver an effective call centre service in order to achieve member satisfaction.
  • Effective Customer Service delivery.
  • Hospital patients visits as and when required.
  • Monitor Cost per Beneficiary and Average Length of Stay.

Qualification - Essential

  • Grade 1
  • B Cur degree / Diploma in Nursing

Experience - Essential

  • Minimum 5 years' experience as a nursing practitioner
  • Minimum 1 year experience gained in the medical funding industry

Job Types:
Full-time, Permanent

Education:

  • Diploma (required)

Experience:

- nursing: 5 years (required)

- medical aid industry: 1 year (required)

Ability to Relocate:

  • Pretoria, Gauteng: Relocate before starting work (required)

  • Case Manager

    2 weeks ago


    Pretoria, Gauteng, South Africa H2R Africa Full time

    Our client, who is in the Health Care Industry, has a vacancy for a Case Manager on a Permanent basisThe Case Manager will have thorough, well-grounded clinical knowledge of hospital admissions, LOS and LOCExcellent knowledge of the South African Healthcare industry and prevailing legislation, current coding structures i.e., ICD10's, CPT4, NRPL, PMB...

  • Case Manager

    2 weeks ago


    Pretoria, Gauteng, South Africa Dymaxa Recruitment Full time

    Our client, specializing in the labour relations industry, is seeking a Case Manager/Office Supervisor to be based in Pretoria. You will manage the overall Case Management function, nationally, as well as be responsible for the direct administration of cases for various areas (currently, Gauteng-Pretoria, Mpumalanga, Northwest, Limpopo, Eastern Cape (PE/East...

  • Case Manager

    2 weeks ago


    Pretoria, Gauteng, South Africa iMedrecruit Full time

    About the job Case Manager (Member Management) 12 Month FTC - PretoriaCase Manager (Member Management) 12 Month FTC - PretoriaOur client, focusing on a risk and clinical assessment offering, is requiring a Case Manager (Member Management).Requirements (but not limited to) Perform Clinical coding in accordance with CPT and ICD requirements and as per client...

  • Case Manager

    2 weeks ago


    Pretoria, Gauteng, South Africa care force Full time

    Our client, a managed care organisation based in Pretoria is looking for a Case Manager. This is an equal opportunity organisation with various businesses and/ or subsidiaries that service clients in the medical scheme and insurance industries.Position: Case Manager (Member Management)Reporting to: Senior Specialist Clinical ManagementLocation: On-site at...

  • Case Manager

    2 weeks ago


    Pretoria, Gauteng, South Africa H2R Africa Full time

    Qualifications:Enrolled/ Registered NurseValid registration with SANCSkills and Competencies Required:3 to 5 years experience within a managed healthcare or medical scheme environmentSolid understanding of value-based careDemonstrated ability to manage a portfolio of hospital casesOutcome focused with the ability to manage competing demandsEstablishing and...

  • Case Manager

    2 weeks ago


    Pretoria, Gauteng, South Africa H2R Full time

    Gauteng, Tshwane (Pretoria) Monthly Cost To Company (Market related, Negotiable)Our client, who is in the Health Care Industry, has a vacancy for a Case Manager on a Contract Basis, with a possibility of it becoming permanentThe Case Manager will have thorough, well-grounded clinical knowledge of hospital admissions, LOS and LOCExcellent knowledge of the...

  • Case Manager

    2 weeks ago


    Pretoria, Gauteng, South Africa Dymaxa Recruitment Full time

    Our client, specializing in the labour relations industry, is seeking a Case Manager/Office Supervisor to be based in Pretoria. You will manage the overall Case Management function, nationally, as well as be responsible for the direct administration of cases for various areas (currently, Gauteng-Pretoria, Mpumalanga, Northwest, Limpopo, Eastern Cape (PE/East...

  • Case Manager

    2 weeks ago


    Pretoria, Gauteng, South Africa iMedrecruit Full time

    Case Manager (Member Management) 12 Month FTC - PretoriaOur client, focusing on a risk and clinical assessment offering, is requiring a Case Manager (Member Management).Requirements (but not limited to) Perform Clinical coding in accordance with CPT and ICD requirements and as per client standards. Maintaining patient's clinical status in accordance with...

  • Case Manager

    2 weeks ago


    Pretoria, Gauteng, South Africa Qetello Holdings Full time

    Functions: Plan and optimise daily tasks to ensure timely updates of cases on the hospital list. Follow up on longterm and highcost cases of hospitalised and home care patients. Identify the need for patient and hospital visits and provide documented feedback. Adhere to the escalation process for cases requiring input from management or the medical advisor....


  • Pretoria, Gauteng, South Africa Medical Protection Society Full time

    Job Introduction:We have an exciting role for a Case Management Assistant to sit within our South Africa Cases Team.Working within the South Africa Case Management team you will support the delivery services for South Africa members, providing assistance to Medico and Dento Legal Consultants, and Case Managers.Role Responsibility: Assist the Medico and Dento...


  • Pretoria, Gauteng, South Africa Medical Protection Society Full time

    Job Introduction We have an exciting role for a Case Management Assistant to sit within our South Africa Cases Team.Working within the South Africa Case Management team you will support the delivery services for South Africa members, providing assistance to Medico and Dento Legal Consultants, and Case Managers.Main Responsibilities Assist the Medico and...

  • Case Manager Hbm

    2 weeks ago


    Pretoria, Gauteng, South Africa Dymaxa Recruitment Full time

    Our client, a non-profit, medical scheme is seeking a Case Manager HBM in the Gauteng area. Delivering of cost-effective managed healthcare service to accomplish member satisfaction.Behavioural Competency Strong organizational skills, attention to detail and ability to prioritize. Strong communication skills in English and Afrikaans. Ability to work in a...

  • Case Administrator

    2 weeks ago


    Pretoria, Gauteng, South Africa Business Capital Group Full time

    Facility Life Eugene Marais HospitalPosition:Case AdministratorIntroductionCritical OutputsEnsure operational excellence Coordinate and distribute case management working reports to team. Assist case managers assigned to specialized wards to compile motivations where required and submit to the fund. Ensure effective management of real time and manual...

  • On Site Case Manager

    2 weeks ago


    Pretoria, Gauteng, South Africa Unique Health Full time

    ON SITE Case Manager / Travel Nurse - PRETORIA EAST Must be a Registered Nurse Must be fluent in Afrikaans and English Must be registered with SANC Must have own small vehicle and must be prepared to travel Must have Case management experience Must have disease management experience*Previous experience of hospital on site visits and assessments essential...

  • On Site Case Manager

    2 weeks ago


    Pretoria, Gauteng, South Africa Unique Health Full time

    ON SITE Case Manager / Travel Nurse - WEST CAPE Must be a Registered Nurse Must be fluent in Afrikaans and English Must be registered with SANC Must have own small vehicle and must be prepared to travel Must have Case management experience Must have disease management experience*Previous experience of hospital on site visits and assessments essential Must...


  • Pretoria, Gauteng, South Africa Dymaxa Recruitment Full time

    Our client, specializing in the labour relations industry, is seeking a Case Manager/Office Supervisor to be based in Pretoria. You will manage the overall Case Management function, nationally, as well as be responsible for the direct administration of cases for various areas (currently, Gauteng-Pretoria, Mpumalanga, Northwest, Limpopo, Eastern Cape (PE/East...


  • Pretoria, Gauteng, South Africa Church World Service Full time

    Position Title: Case Processing AssistantReports To: Case Processing SupervisorDivision: Immigration & Refugee Program+ (IRP+)Department: Programs, Case ProcessingJob Location: Pretoria, South AfricaGrade Level: Level 3, Assistant, NationalIntroduction: Church World Service (CWS) is a not-for-profit, faith-based organization transforming communities around...


  • Pretoria, Gauteng, South Africa Cirrus Recruitment Full time

    These jobs were popular with other job seekers Aryxs Health Pty Ltd / The IV Bar Bryanston and The IV Bar BluBird Aryxs Health Pty Ltd / The IV Bar Bryanston and The IV Bar BluBird Communicate on several platforms with a multi-disciplinary team as well as funders externally.Curator for all outgoing reporting to fundersProvide appropriate information to...


  • Pretoria, Gauteng, South Africa Church World Service Full time

    Position Title: Case Processing SupervisorReports To: Case Processing ManagerDivision: Immigration & Refugee Program+ (IRP+)Department: Programs, Case ProcessingJob Location: Pretoria, South AfricaGrade Level: Grade 7, Supervisor, NationalIntroduction: Church World Service (CWS) is a not-for-profit, faith-based organization transforming communities around...

  • Hbm Case Manager

    2 weeks ago


    Pretoria, Gauteng, South Africa Medpharm Recruitment Full time

    A reputable Medical Aid based in Pretoria is seeking a Case Manager to join their HBM team.Job purpose: Delivering a costeffective Managed Healthcare service to accomplish member satisfaction.Qualification / Experience: Grade 12 / Matric B Cur Degree or Diploma in Nursing SANC Registered A minimum of 5 years' experience as a Nursing Practitioner A minimum of...