Case Manager
2 weeks ago
Responsibilities
- 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’ progress in cases where the prognosis may indicate that the costs may exceed limitations imposed.
- Develop a strong relationship with Doctors, be sensitive and professional.
- Educate staff and Doctors on new Developments from Managed Care Organizations.
- Ensure the accuracy of all data relative to diagnosis, procedures, and matching coding CPT4 and ICD10 and any other coding required by Managed Care Organizations.
- Assist in the audit process to ensure that billings are accurate and timeous.
- Daily Ward rounds to manage care of patients effectively, with the Medical Aids
**Requirements**:
- Standard 10 (Grade 12).
- Must have completed basic ICD10 and CPT Coding Courses.
- Registered Nurse/Senior Enrol Nurse with a five-year experience, ideally ICU and NICU experience essential.
- Must have worked in a Private Hospital for two years doing Case Management.
- Extensive Clinical Skills.
- Ability to increase Revenue and Turnover.
**Skills**:
- Mature and Professional attitude, personality, and character traits.
- Sound reputation credibility with doctors.
- Capable of administration duties.
- Capable of working to large extend on their own.
- Very good interpersonal communication skills, to build sound relationship with doctors, patients, medical aid contact person/s and with other Hospital Departments.
- Task orientated and the ability to work under tremendous pressure.
- Business orientated - Highly motivated, “go-getter”.
- A high level of accuracy and meticulousness is required.
- Ability to increase Revenue and Turnover
- **The LPHH is an equal opportunity Employer whose recruitment decisions are based on merit and the selection process is made without/regards to race, colour, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, or any other protected classification.**_
**CLOSING DATE: 17 December 2024**
**Job Types**: Full-time, Permanent
Application Deadline: 2024/12/17
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