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Clinical Case Management Specialist

1 week ago

Johannesburg, Gauteng, South Africa Mediclinic International Full time
Key Responsibilities
  • Case Management Coordination: Minimize financial risk by effectively managing patient stay, ensuring compliance to case management procedures, contracts and legal aspects, and facilitating timely finalization of cases for reimbursement.
  • Communication and Collaboration: Consistently and timeously communicate with funders as contractually agreed through relevant case management channels, adhering to clinical coding standards as per Level 3 coding guideline.
  • Team Leadership: Lead and manage the people in the Case Management team, ensuring they have the necessary resources and support to excel in their roles.

Requirements

  • Education: Registered Nurse / Professional Nurse or qualified Paramedic, with a strong understanding of anatomy, physiology, and terminology.
  • Experience: Minimum of 3 years in a clinical role, preferably in Theatre and/or ICU, with experience in private healthcare environments or as an ILS/ALS Paramedic.
  • Skills: Scientific nursing principles, funder contracts, medical aid requirements, B2B EMS, authorisation and motivation of Level of Care, Patient Administration policies and procedures, and Level 3 coding.