Clinical Case Manager

2 weeks ago


Pietermaritzburg, KwaZulu-Natal, South Africa Immploy Recruitment Agency CC Full time
Job Title: Case Manager

We are seeking a highly skilled and experienced Case Manager to join our team at Immploy Recruitment Agency CC. As a Case Manager, you will play a critical role in ensuring the efficient management of patient cases and the delivery of high-quality services to our internal and external customers.

Key Responsibilities:
  • Clinical Coding: Ensure that clinical coding is carried out in accordance with CPT and ICD requirements.
  • Pre-Admission and Pre-Authorisation: Verify that pre-admission and pre-authorisation information is accurate and in line with hospital and funder procedures.
  • Patient Clinical Status: Maintain patients' clinical status in accordance with funder approval requirements throughout their hospital stay, keeping patients informed and managing financial risk.
  • Account Updates and Discharge Information: Provide complete and accurate updates and discharge information for all accounts.
  • Accurate Accounts: Maintain accurate accounts of all admissions.
  • Patient Files: Handle patient files in accordance with hospital procedures, ensuring timely electronic submission of accounts and follow-up on short payments related to case management issues.
  • Funder Rules and Coding Procedures: Ensure adherence to funder rules and coding procedures among hospital staff.
  • Legislation and Healthcare Matters: Stay informed on legislation related to funders and healthcare matters.
Minimum Requirements:
  • SANC Registration: Possess SANC registration as a Registered Nurse or an Enrolled Nurse.
  • Case Management Experience: Have at least 5 years' experience as a case manager, either at hospital level or with medical schemes (preferably with case management experience at hospital level).
  • Medical Aid Administration: Have experience with medical aid administration procedures, including ICD10, CPT 4 Procedure Codes, and Per Diems.
  • Hospital Billing and Tariffs: Knowledge of hospital billing and tariffs, as well as Hospital Information System, is advantageous.
  • Stakeholder Relations: Possess the ability to build good relations with various internal and external stakeholders.


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