Hospital Case Manager
5 days ago
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 EDUCATION : Clinical qualification DESIRED EDUCATION : Registered Nurse / Professional Nurse or qualified Paramedic REQUIRED EXPERIENCE ESSENTIAL MINIMUM EXPERIENCE : Minimum of 3 years in a clinical role DESIRED EXPERIENCE : 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 Understanding of anatomy; physiology and medical terminology Funder Contracts; Medical aid requirements / narrations Scientific nursing principles and process Authorisation and motivation of Level of Care; Length of Stay; Clinical Coding, high-cost stock, Short Payments etc. Use of electronic systems (i.e. B2B or Funder portals) for the purposes of requesting authorisations, performing case management updates and for troubleshooting Computer literacy (Microsoft Office, hospital / practice management systems) 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; clinical coding; and case management processes Application of clinical codes and finalisation thereof #J-18808-Ljbffr
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Case Manager
6 days ago
Pretoria, South Africa Louis Pasteur Private Hospital Full timeResponsibilities - To monitor all aspects of patients who are admitted under a Managed Care Limitation and through the co-ordination and liaison with the Doctors, Managed Care Organization and Hospital Nursing staff, ensures that the treatment provided meets the requirements of the Managed Care Organization. - Liaise with Doctors regarding their patients’...
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Case Manager
4 days ago
Pretoria, South Africa H2R Africa Full time**Qualifications**: Enrolled/ Registered Nurse Valid registration with SANC **Skills and Competencies Required**: 3 to 5 years experience within a managed healthcare or medical scheme environment Solid understanding of value-based care Demonstrated ability to manage a portfolio of hospital cases Outcome focused with the ability to manage competing...
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Case Manager
3 weeks ago
Pretoria, South Africa Dymaxa Full timeOur client, a non‑profit medical scheme, is seeking a Case Manager HBM in the Pretoria area. Overview Delivering cost‑effective managed healthcare service to achieve member satisfaction. Behavioural Competency Strong organizational skills, attention to detail and ability to prioritize. Strong communication skills in English and Afrikaans. Ability to work...
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Case Coordinator
1 week ago
Pretoria, South Africa PRETORIA OOGINSTITUUT HOSPITALE BEDRYF Full time**JOB PURPOSE** The main purpose of this position is to coordinate the hospital pre-authorisations, confirmations, billing and credit control processes and facilitate the communication process between all role players by providing accurate and timeous clinical information to minimize the financial risk for the organisation including its...
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Case Manager
2 days ago
Pretoria, South Africa Dymaxa Full time**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 London) and Free State. Your primary goal will be to manage the...
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Hospital Case Manager — Care Coordination
2 weeks ago
Pretoria, South Africa Mediclinic Legae Full timeA leading healthcare provider in Pretoria is seeking a healthcare coordinator to oversee case management processes. Responsibilities include managing patient stays, ensuring compliance with procedures, and communicating with funders. The ideal candidate will have a clinical qualification and at least 3 years of clinical experience, preferably in Theatre or...
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Hospital Plant Operations Leader
7 days ago
Pretoria, South Africa St. John'S Riverside Hospital Full timeA healthcare provider in Pretoria seeks a Plant Operations Manager responsible for overseeing hospital equipment and systems, managing construction projects, and ensuring efficient maintenance operations. The ideal candidate must have strong communication skills, experience in construction, and budget management capabilities. This role requires at least five...
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On Site Case Manager
6 days ago
Pretoria, South Africa Unique Health Full timeON 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...
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Veterinarian
7 days ago
Pretoria, South Africa Dr Darko Veterinary Hospital Full timeJob Details Job Title Veterinarian **_MINIMUM REQUIREMENTS: BVSc_** For Veterinary position RESPONSIBILITIES: The incumbent will be responsible for: Rendering veterinary service at the Dr Darko Veterinary Hospital. Services will be rendered at Dr Darko Hospital Diagnostic work-up of and developing therapeutic plans for all new cases presented. Directing...
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Junior Manager Hospitality
3 weeks ago
Pretoria, South Africa Lapamanzi Restaurant Full timeCompany Description We suggest you enter details here Role Description This is a full‑time on‑site role for a Junior Manager at Lapa Pub / Restaurant, Fourways, located in Gauteng, South Africa. The Junior Manager will be responsible for overseeing daily operations, managing staff, ensuring customer satisfaction, and maintaining high standards in food...
