Hospital Case Manager

1 week ago

Cape Town, South Africa MHR Full time

**Job Advert Summary**:
MHR is urgently looking fo**r **an experienced **Hospital Case Manager** to work at a private hospital in **Panorama** in** Cape Town** ( Western Cape province). This is an opportunity to work **daily fixed shifts** until **end of March**.

**Working hours**: 07:30 - 16:30

**Minimum Requirements**:
**Requirements**:

- **Must be available immediately**:

- Registered with the South African Nursing Council as a Professional Nurse or with the HPCSA as a qualified paramedic
- Case management experience is essential
- Desired experience: Experience in Theatre and or ICU; Medical aid background; Experience in private healthcare environment or experience as an ALS Paramedic
- Intermediate knowledge of Microsoft Office suite
- Knowledge of the Scientific Nursing Process and associated procedures will be an advantage
- Knowledge of the rules and regulations regarding medical aid schemes will be an advantage
- Knowledge of clinical codes and coding policies
- Knowledge of patient administration systems, policies and procedures will be an advantage
- Experience in a Managed Healthcare environment will be a strong recommendation
- Independent problem-solving and decision-making skills
- Good accuracy and attention to detail skills in order to maintain high standards of work output

**Duties and Responsibilities**:

- Responsible for the case management processes
- Interacts with medical schemes to ensure that authorisations are provided timeously
- Verification of clinical coding as per policies and procedures
- Provides support for the management of alternative fee structures
- Liaison with doctors on funder requirements when necessary
- Continuous performance and quality management
- Interpretation and implementation of scheme benefit rules
- Maintains client service principles to ensure client expectations are met

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