Hospital Case Manager

1 week ago

Newcastle, KwaZulu-Natal, South Africa MHR Full time R90 000 - R120 000 per year
Job Advert Summary

MHR is urgently looking for an experienced Hospital Case Manager (Registered nurse or paramedic) to work part-time shifts at a private hospital in Newcastle in Kwa-Zulu Natal province.

Working hours: 07:00 - 16:00

BENEFITS:

  • Competitive pay rates
  • Flexible payment options
  • Placement opportunities at various clients across South Africa
  • Complimentary indemnity cover at specified clients
Minimum Requirements
  • Must be available immediately
  • Registered with the South African Nursing Council as a Registered Nurse or with the HPCSA as a qualified paramedic
  • Experience as an ALS Paramedic is essential (Paramedic)
  • Case management experience is essential
  • Experience in private healthcare environment
  • Knowledge of the Scientific Nursing Process and associated procedures
  • Knowledge of the rules and regulations regarding medical aid schemes
  • Knowledge of clinical codes and coding policies
  • Knowledge of patient administration systems, policies and procedures
  • Proficient in Microsoft Office (Word, Excel and Outlook)
  • 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
  • Ensures accurate application and interpretation of specialised wards criteria
  • 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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