Healthcare Case Coordinator

2 months ago

Pretoria, Gauteng, South Africa MediHelp Full time
Position: Healthcare Case Coordinator

Location: Tshwane Metro, Pretoria, Brooklyn

Employment Type: Permanent, Full-Time

Industry Focus: Insurance and Healthcare

Key Responsibilities:
  • Organize and streamline daily operations to ensure timely updates on patient cases within an 8-hour timeframe.
  • Monitor long-term and high-cost cases for hospitalized and home care patients.
  • Assess the necessity for patient and hospital visits when applicable and provide documented insights.
  • Adhere to the escalation protocol for cases needing management or team intervention.
  • Handle phone inquiries from clients and service providers efficiently.
  • Coordinate care services for members to minimize re-admissions and health complications.
  • Negotiate tariffs and discounts in accordance with scheme regulations.
  • Identify hospitalized members suitable for transfer to rehabilitation or private nursing facilities.
  • Initiate discharge planning at the beginning of hospital stays.
  • Educate families about short-term medical benefits and general care exclusions.
  • Communicate discharge plans and benefits to all relevant parties.
  • Document all communications with involved parties.
  • Compile and record all pertinent information accurately.
  • Relay clinical funding recommendations through hospital authorization notes to healthcare professionals, members, and support staff.
  • Manage complex and high-cost cases that could financially impact the scheme.
Qualifications Required:

A completed degree or diploma in nursing, with registration from the South African Nursing Council (SANC).

Experience and Skills:
  • A minimum of four years in Managed Healthcare, particularly in oncology or related fields.
  • Previous experience in a comparable role.
  • Proficient in managing and prioritizing workload effectively.
  • Strong communication and interpersonal abilities.
  • Exceptional negotiation skills.
  • Familiarity with hospital protocols and medical terminology.
Preferred Qualifications:

Additional certifications in case management or healthcare administration.

Work Environment: This role involves an office setting, engaging in phone communications and interactions with clients and healthcare providers regularly.

Company Overview: Medihelp proudly serves over 215,000 South Africans, fostering a vision of promoting healthy and confident lives across all stages.

  • Healthcare Case Coordinator

    2 months ago

    Pretoria, Gauteng, South Africa MediHelp Full time

    Job Title: Case Manager - Medical AidLocation: Tshwane Metro, Pretoria, BrooklynJob Type: Permanent, Full-TimePrimary Industry: InsuranceSecondary Industry: Health, Medical and relatedKey Responsibilities:Organize and prioritize daily activities to ensure timely updates on patient cases within the required turnaround time.Monitor and follow up on long-term...

  • Healthcare Case Coordinator

    2 months ago

    Pretoria, Gauteng, South Africa MediHelp Full time

    Job Title: Case Manager - Medical AidLocation: Tshwane Metro, Pretoria, BrooklynJob Type: Permanent, Full-TimePrimary Industry: InsuranceSecondary Industry: Health, Medical and relatedKey Responsibilities:Organize and prioritize daily responsibilities to ensure timely updates on patient cases.Monitor and follow up on long-term and high-cost cases involving...

  • Senior Case Coordinator

    5 days ago

    Pretoria, Gauteng, South Africa Qetello Holdings Full time

    Job Title: Senior Case CoordinatorAbout the Role:The Senior Case Coordinator will play a vital role in ensuring the timely and efficient management of cases within the medical scheme. This includes planning and optimizing daily tasks, following up on long-term and high-cost cases, and identifying the need for patient and hospital visits.Key...

  • Case Manager

    1 month ago

    Pretoria, Gauteng, South Africa MediHelp Full time

    Job Title: Case Manager - Medical AidMediHelp is seeking a skilled Case Manager to join our team in Tshwane Metro, Pretoria, Brooklyn. As a Case Manager, you will play a crucial role in ensuring the smooth delivery of healthcare services to our members.Key Responsibilities:Plan and optimize daily tasks to update cases on the hospital list within the 8-hour...

  • Case Manager

    1 month ago

    Pretoria, Gauteng, South Africa Qetello Holdings Full time

    Job Title: Case ManagerWe are seeking a dedicated and experienced Case Manager to join our team at Qetello Holdings. As a Case Manager, you will play a critical role in ensuring the timely and effective management of healthcare benefits for our members.Key Responsibilities:Plan and optimize daily tasks to ensure timely updates of cases on the hospital...

  • Medical Aid Case Manager

    2 months ago

    Pretoria, Gauteng, South Africa MediHelp Full time

    Job Title: Medical Aid Case ManagerLocation: Tshwane Metro, Pretoria, BrooklynJob Type: Permanent, expected to work Full-Time hoursPrimary Industry: InsuranceSecondary Industry: Health, Medical and relatedJob Duties:Plan and optimize daily tasks to update cases on the hospital list within the 8-hour turnaround timeFollow up on long-term and high-cost cases...

  • Clinical Case Supervisor

    1 month ago

    Pretoria, Gauteng, South Africa Qetello Holdings Full time

    About Qetello Holdings: Qetello Holdings is a prominent organization in the healthcare sector, dedicated to delivering exceptional medical benefits to its clientele. We pride ourselves on our commitment to innovation and quality service, ensuring the well-being of our members.Position Overview: We are currently seeking a skilled and compassionate Case...

  • Case Manager

    4 weeks ago

    Pretoria, Gauteng, South Africa MediHelp Full time

    Job Title: Case Manager - Medical AidMediHelp is seeking a skilled Case Manager to join our team. As a Case Manager, you will be responsible for managing and coordinating the care of our members, ensuring they receive the best possible medical treatment and support.Key Responsibilities:Plan and optimize daily tasks to update cases on the hospital list within...

  • Case Manager

    4 weeks ago

    Pretoria, Gauteng, South Africa MediHelp Full time

    Job Title: Case Manager - Medical AidMediHelp is seeking a skilled Case Manager to join our team in Tshwane Metro, Pretoria, Brooklyn. As a Case Manager, you will play a critical role in ensuring that our members receive the best possible care and support.Key Responsibilities:Plan and optimize daily tasks to update cases on the hospital list within the...

  • Case Manager

    4 weeks ago

    Pretoria, Gauteng, South Africa MediHelp Full time

    Job Title: Case Manager - Medical AidMediHelp is seeking a skilled Case Manager to join our team in Tshwane Metro, Pretoria, Brooklyn. As a Case Manager, you will play a crucial role in ensuring that our members receive the best possible care and support.Key Responsibilities:Plan and optimize daily tasks to update cases on the hospital list within the 8-hour...

  • Orthopaedic Case Manager

    2 days ago

    Pretoria, Gauteng, South Africa H2R Africa Full time

    Job Title: Case Manager for Spinal Management ProgrammeJob Summary:H2R Africa is seeking a highly skilled Case Manager for Spinal Management Programme to join our team. The successful candidate will be responsible for managing the access, clinical appropriateness, and risk of all requests for services pertaining to back and neck pain management, spinal...

  • Spinal Management Program Case Manager

    4 weeks ago

    Pretoria, Gauteng, South Africa H2R Africa Full time

    Job Title: Spinal Management Program Case ManagerWe are seeking a highly skilled and experienced Case Manager to join our team at H2R Africa. As a Case Manager for our Spinal Management Program, you will play a critical role in ensuring the effective management of patients with back and neck pain.Key Responsibilities:Actively manage the access, clinical...

  • Medical Case Manager

    5 days ago

    Pretoria, Gauteng, South Africa Qetello Holdings Full time

    Job SummaryQetello Holdings is seeking a dedicated and experienced Case Manager to join their team. The ideal candidate will have a B Cur Degree / Diploma in Nursing and a minimum of 5 years of experience as a nursing practitioner.Key Responsibilities:Plan and optimize daily tasks to ensure timely updates of cases on the hospital list.Follow up on long-term...

  • Social Worker, Weekdays, Therapeutic Nursery Program

    4 weeks ago

    Pretoria, Gauteng, South Africa Adventist HealthCare Full time

    Job Title: Social Worker, Weekdays, Therapeutic Nursery ProgramWe are seeking an experienced Social Worker to join our team at The Lourie Center Therapeutic Nursery Program. As a Social Worker, you will play a vital role in providing comprehensive psychosocial assessments, individual, group, and family therapies, and participating in an interdisciplinary...

  • Spinal Management Program Case Manager

    1 month ago

    Pretoria, Gauteng, South Africa H2R Africa Full time

    Job Title: Case Manager for Spinal Management ProgramWe are seeking a highly skilled and experienced Case Manager to join our team at H2R Africa. The successful candidate will be responsible for managing the access, clinical appropriateness, and risk of all requests for services pertaining to back and neck pain management, spinal surgery, scans, and...

  • Spinal Management Program Case Manager

    3 weeks ago

    Pretoria, Gauteng, South Africa H2R Africa Full time

    Job Title: Case Manager for Spinal Management ProgramWe are seeking a highly skilled and experienced Case Manager to join our team at H2R Africa. The successful candidate will be responsible for managing the access, clinical appropriateness, and risk of all requests for services related to back and neck pain management, spinal surgery, scans, and associated...

  • Care Activities Coordinator

    2 months ago

    Pretoria, Gauteng, South Africa Guardian Healthcare Full time

    About the RoleWe are seeking a highly motivated and compassionate Activities Coordinator to join our team at Guardian Healthcare. As an Activities Coordinator, you will play a vital role in creating and delivering engaging activities and events that promote the independence and well-being of our residents.Our residents are at the heart of everything we do,...

  • Care Activities Coordinator

    2 months ago

    Pretoria, Gauteng, South Africa Guardian Healthcare Full time

    About the RoleWe are seeking a highly motivated and compassionate Activities Coordinator to join our team at Guardian Healthcare. As an Activities Coordinator, you will play a vital role in creating and delivering engaging activities and events that promote the independence and well-being of our residents.Our residents are at the heart of everything we do,...

  • Healthcare Compliance Specialist

    2 months ago

    Pretoria, Gauteng, South Africa beBee Professionals Full time

    Healthcare Compliance Coordinator RoleWe are seeking a skilled Healthcare Compliance Coordinator to ensure our organization's compliance with healthcare regulations and standards.Key Responsibilities:Develop and implement compliance policies and proceduresMonitor compliance with applicable regulations and standardsProvide guidance and training to staff on...

  • Healthcare Compliance Specialist

    2 months ago

    Pretoria, Gauteng, South Africa beBee Professionals Full time

    Healthcare Compliance Coordinator RolebeBee Professionals is seeking a skilled Healthcare Compliance Coordinator to ensure the organization's compliance with healthcare regulations and standards.Key Responsibilities:Develop and implement compliance policies and proceduresMonitor compliance with applicable regulations and standardsProvide guidance and...