Case Manager

2 days ago


Johannesburg, South Africa Clinix Health Group (Pty) Ltd Full time

**Job Summary**:
To deliver an effective case management process and facilitate the communication process between all role-players by providing accurate and timeous clinical information in order to minimize the financial risk for the company.

**Minimum Qualifications and Experience**:

- Grade 12.
- Registered Nurse, currently registered with SANC.
- Alternatively, an Enrolled Nurse currently registered with SANC.
- Certificate in Coding (advantageous).
- 3 to 5 years’ experience in a private hospital or medical scheme environment in a Case management capacity.
- Working knowledge of ICD-10 and CPT codes.
- Computer proficiency - SAP System or similar.

**Minimum Job Requirements**:

- Ensure authorizations on admissions (daily) is accurate as per SAP system.
- Conduct daily case management rounds in allocated units to obtain updated clinical information from patient files. Comply with case management procedures, Medical Scheme contracts and legal aspects by utilizing available resources and systems (specifically the Case Manager Workstation on SAP).
- Communicate consistently and timeously with the Medical Schemes as contractually agreed through the relevant case management channels.
- Obtain Doctors letters of motivation in support of all cases where Medical Schemes request these from the hospital as part of their assessing process.
- Minimize financial risk by effectively managing patient stay.
- Communicate daily statistics with Billings regarding number of files with case management and with Billings, to progress these files through the system as quickly as possible and to achieve the discharge to final bill target. Resolve queries related to short payments by Medical Scheme, in conjunction with the Collections Department.


  • Case Manager

    4 weeks ago


    Johannesburg, South Africa Digicall Group Full time

    The Case Manager is responsible for answering inbound or internally transferred calls, assessing the caller's needs, taking ownership of the issue, and coordinating an appropriate solution using internal or external resources. Qualifications Minimum of 2 years' experience in a call centre environment. Minimum of 1 year experience in Roadside Assistance....

  • Case Manager

    2 weeks ago


    Johannesburg, South Africa Digicall Group Full time

    The Case Manager is responsible for answering inbound or internally transferred calls, assessing the caller's needs, taking ownership of the issue, and coordinating an appropriate solution using internal or external resources. Qualifications Experience Minimum of 2 years’ experience in a call centre environment. Minimum of 1 year experience in Roadside...

  • Case Manager

    2 weeks ago


    Johannesburg, South Africa Clinix Health Group (Pty) Ltd Full time

    **Job Summary**: To plan, coordinate and execute case management work at hospital level. The incumbent utilities clinical knowledge to minimise financial risk and ensure accurate billing through comprehensive accurate coding of patient care. **Minimum Qualifications and Experience*** - Nursing degree / diploma. - Current registration with South African...

  • Case Manager

    2 days ago


    Johannesburg, Gauteng, South Africa Glasshouse Recruiting Full time

    Ensure compliance to case management procedures, standards and protocols.Plan, coordinate and execute Clinical coding in accordance with relevant company standards and protocols.Timeously and consistently communicate and follow up with Funders (Medical Aids, COID, Government, RAF, DOL, etc.)Provide appropriate clinical information to Funders in order to...

  • Hospital Case Manager

    4 weeks ago


    Johannesburg, South Africa Mediclinic Full time

    Job title : Hospital Case Manager Job Location : Gauteng, Johannesburg Deadline : November 18, 2025 Quick Recommended Links Jobs by Location Job by industries MAIN PURPOSE OF JOB To coordinate the hospital case management process and facilitate the communication process between all role players by providing accurate and timeous clinical information to...

  • Case Manager

    6 days ago


    Johannesburg, South Africa Mass Staffing Projects Full time

    Open vacancy in Gauteng! Looking for a someone that will be responsible for the liaison between the patients and managed healthcare. **Requirements**: - B Degree Nursing Qualification or equivalent NQF level 6 - Hospital case manager experience advantageous - 3 years’ experience in patient care - SAP experience preferrable

  • Case Manager

    2 weeks ago


    Johannesburg, South Africa Mass Staffing Projects Full time

    **Requirements**: - Degree/Diploma in Nursing - Minimum 4 years nursing experience in a multidisciplinary hospital environment - Intensive Care nursing experience is an advantage - Hospital or Medical Scheme Case Management an advantage - Experience in ICD 10 and CPT 4 coding an advantage


  • Johannesburg, South Africa Motor Industry Bargaining Council Full time

    **Duties & Responsibilities** - Monitor and account for stationery, consumable levels - Attend to professional drafted correspondence, serving and courier documents - Generate case management Reports when requested - Assist at reception(front office) or other Case Manager’ when required, - Book venues, Interpreters and Panelist for cases with proper notice...

  • Hospital Case Manager

    4 weeks ago


    Johannesburg, South Africa Mediclinic International Full time

    Choose how often (in days) you want to receive a notification : Mediclinic Sandton| Bryanston, Johannesburg | South Africa Closing date : 17 / 11 / Number of positions : 1 Recruiter name : Nomsa Rachel Somzila Reference number : Workplace Type : On-site Permanent Please note if you are an internal employee on a fixed term contract please apply using an...

  • Case Manager

    7 hours ago


    Johannesburg, South Africa Premier Appointments Full time

    **Case Manager** 1. **Qualifications**: - Matric - Registered Nursing diploma - Valid membership of SANC - Claims and Forensic Risk management certification - Registration with the Association of Certified Fraud Examiners (ACFE SA) 2. **Skills and Experience**: - At least 2-3 years’ experience in a similar role. - MIP Application System experience...