Case Manager | General Wards

2 weeks ago

Johannesburg, South Africa Life Healthcare Group Full-time

Free with email or Google

Save this job and keep your search organized

Create a free account to save jobs, create alerts and return to this listing from your dashboard.

Save job Save and create alert

Free with email or Google

By continuing, you agree to our Terms & Privacy Policy.

Function
Patient services
Facility
Life Hilton Private Hospital
Position
Case Manager | General Wards
Introduction

A vacancy exists for a Case Manager General Wards based at Life Hilton Private Hospital, reporting to the Patient Services Manager, Sharona Singh. The successful candidate will be responsible for managing the financial and clinical risks of the patient in a general ward by ensuring accurate coding, clinical updates and accounts submissions of patient hospitalization to achieve strategic objectives.

Critical Outputs

Ensuring the maximisation of revenue by

Ensuring accuracy of coding
Ensuring the correct application and interpretation of RSRT's
Participating in meetings and reporting losses to RSRT team and recommend corrective actions
Monitoring insurance verification and workflow processes

Ensuring effective management of quality outputs by

Performing quality walkabouts and implement corrective measures
Implementing and monitoring quality improvement programmes
Adhering to patient services escalation processes in order to achieve QMS targets
Monitoring Q-evaluator scores and implementing corrective measures
Investigating internal and external stakeholder complaints
Ensuring the adherence to customer service standards

Ensuring operational excellence by

Monitoring submission of accurate accounts to funders
Updating length of stay and level of care to funders of general ward cases and where operationally required specialised unit cases.
Releasing care risk targets and submission within two days of discharge
Ensuring the compliance to LHC policies and managing authorisations and claim submissions, rejections and delays
Ensuring governance and risk management by monitoring and adhering to patient services policies and procedures
Ensuring compliance to service level agreements with internal and external stakeholders
Ensuring all billing checks are closed by the relevant function areas

Ensuring effective management of relationships with internal/external stakeholders by

Building and maintaining relationships with internal stakeholders
Providing feedback and information on concerns or issues raised by internal stakeholders
Providing and facilitating training regarding RSRT contracts to the relevant internal stakeholders
Ensuring effective communication with external stakeholders
Managing escalated concerns from Case Managers with external stakeholders
Escalating doctor non-compliance in terms of RSRT framework to RSRT meetings

Requirements

Diploma or degree in Nursing, Physiotherapy, Clinical Associates, Paramedics as Critical Care Assistants or Emergency Care Practitioners or any other qualification that covers Anatomy, Physiology, Pathophysiology and Microbiology as foundational courses.
Current SANC registration
Atleast 3 years experience as a Case Manager in a Hospital Environment
Knowledge of hospital patient services and case management processes
Knowledge and understanding of CPT & ICD coding
Knowledge of Funder contracts, scheme rules, exclusions and benefits
Understanding of private hospital industry and practices
Computer proficiency

Competencies

Attention to detail
Problem-solving, analysis and judgement
Resilience
Engaging diversity
Verbal & written communication skills
Professional and technical proficiency
Building relationships
Customer responsiveness
Organisational awareness
Influencing skills
Action orientation
Excellence orientation
Ethical behaviour

Closing date
Wednesday, August 19, 2026

Internal applicants - Before making an application, you are requested to discuss your application with your line manager. External candidates will also be considered.

Life Healthcare is an Equal Opportunity Employer.

Thank you for your interest in this opportunity. Kindly note that only shortlisted candidates will be contacted. Applicants who have not been contacted within two weeks of the closing date of this advert, should consider their application as unsuccessful.

Case Manager | General Wards

Save this job and keep your search organized

Similar jobs in Johannesburg

Top cities

Americas

Europe

Asia / Oceania

Africa

Case Manager | General Wards

Save this job and keep your search organized

Similar jobs in Johannesburg

Top cities