Case Manager

6 months ago


Pretoria, 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 12
- 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

Ability to commute/relocate:

- Pretoria, Gauteng: Reliably commute or planning to relocate before starting work (required)

**Education**:

- Diploma (required)

**Experience**:

- Professional nurse: 5 years (required)
- medical aid: 1 year (required)


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