Clinical Case Manager

2 weeks ago


Sandton, South Africa MSO International (Pty) Ltd Full time

**General description of the Job**:
The case manager (CM) is responsible for managing the clinical and financial risk of complicated as well as high-cost cases admitted into private or public healthcare facilities. This includes interacting with all service providers within the multi-disciplinary medical team as well as other stakeholders, in ensuring compliance with service level agreements with the clients contracted into MSO. The case manager is also the client’s advocate in ensuring that members receive quality and cost effective healthcare.

**Overview of Job Requirements**:
A driver’s license or own transport is essential. English fluency and current registration with the South African Nursing Council.

**Education**:

- Grade 12 and a Diploma /Degree in Nursing Science.
- Enrolled or Registered Nurse

**Experience**:

- At least 5 years postgraduate clinical experience

A minimum of 2 years within the managed health care industry

**Duties and Responsibilities included but not limited to**:

- Ensure the delivery of the client SLA by managing the clinical and financial risk of high cost admissions
- Promote patient advocacy
- Timeous screening and activation of referred cases requiring case management interventions
- Ensuring correct CM processes and protocols are adhered to once case management is initiated by implementing clinically and financially cost effective measures
- Bi-weekly system updating of existing case management authorisations
- Accurate recording and reporting of case management data
- Interaction and liaison with healthcare professionals, funder, patient, family and medical advisory team for clinically appropriate and cost effective outcomes
- Facilitating and co-ordinating transfers into alternative hospital facilities
- Onsite visitation of clients in provider hospital/sub-acute and rehab facilities

**Job Type**: Temp to perm

**Education**:

- Diploma (required)

**Experience**:

- postgraduate clinical: 5 years (required)
- managed health care: 2 years (required)

Application Deadline: 2023/01/20


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