Hbm Case Manager

A reputable Medical Aid is seeking a Nurse who has experience within the Medical Aid environment, to join their HBM Case Management team. **Duties**: - Providing clinical knowledge of hospital pre-authorisation and Case Management of hospital cases in order to take cost effective and appropriate decisions in evaluating treatment, LOS and...

A reputable Medical Aid based in Pretoria is seeking a Registered Nurse to join their HBM Case Management team. **Qualifications**: - Grade 12 - B Cur Degree / Diploma in Nursing - SANC Registered **Experience**: - Minimum 5 years experience as a Nursing practitioner - Minimum 1 year experience gained in the Medical Funding industry...

**Functions**: - Plan and optimise daily tasks to ensure timely updates of cases on the hospital list. - Follow up on long-term and high-cost 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...

A reputable Medical Aid based in Pretoria is seeking a Clinical Research & Development Specialist to join their Hospital Benefit Management Department. **Job Purpose**: - Research, develop and maintain funding guidelines for use by Hospital Benefit Management teams. - Assess the clinical and health economic attribute of innovative health technologies and...

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 Management Location: On-site...

Job Introduction The Member Cases and Claims Division is at the forefront of protecting the careers, reputation and financial risk of our members worldwide. The purpose of the role is to support the provision of excellent case handling services for members which is trusted and valued and provides fair treatment and outcomes. The role will do this by...

**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...

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 permanent The Case Manager will have thorough, well-grounded clinical knowledge of hospital admissions, LOS and LOC Excellent knowledge of...

**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...

**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. **Duties and responsibilities** Delivering of cost-effective managed healthcare service to accomplish member satisfaction. - Case management of authorised cases according to the acceptable Scheme...

**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...

**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...

**Duties and Responsibilities** - Plan and optimize daily tasks to update cases on the hospital list within the 8 hours turnaround time. - Following up on long term and high cost cases of hospitalised and home care patients. - Identify the need for patient and hospital visits where possible and give documented feedback. - Follow the escalation process for...

**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...

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...

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...

Our client is looking for a Junior Pre-Auth Consultant (HBM) to deliver cost-effective managed healthcare services primarily via email correspondence, ensuring member satisfaction. The ideal candidate will have a Grade 12 qualification, Auxiliary Nursing certification, active SANC membership, a minimum of 5 years' experience as a nursing practitioner, and at...

Our client is looking for a Junior Pre-Auth Consultant (HBM) to deliver cost-effective managed healthcare services primarily via email correspondence, ensuring member satisfaction. The ideal candidate will have a Grade 12 qualification, Auxiliary Nursing certification, active SANC membership, a minimum of 5 years' experience as a nursing practitioner, and at...

Our client is a leading medical scheme based in Pretoria, dedicated to providing comprehensive healthcare benefits to its members. They are committed to innovation, quality service, and the well-being of their clients. In line with their growth and commitment to excellence, they are seeking a dedicated and experienced Case Manager to join their...

**Role Responsibility**: - Assist the Medico and Dento Legal Consultants and Case Managers with all case related activities. - Answering phone calls from members, addressing, and resolving queries and providing excellent service. - Assessing the initial case to determine the appropriate strategy, allocating and completing tasks, and recording the agreed...