Jobs: case manager hospital risk management

Following the JMH policy with regards to clinical updating within turnaround times and service level agreements.Accurate and complete ICD 10/ CCSA coding.Month end deadlines.Ensure accurate and complete billing.Ensure adequate and appropriate information is communicated about the medical schemes.To manage the internal DSO and ensure optimization of tools...

Position:Case Manager In HospitalPosition Purpose:To coordinate care in allocated facilities, in order to improve health outcomes and manage the cost to the Scheme(/s). The case manager's responsibilities start from patient admission to discharge and they should have an understanding of hospital processes and the importance of making cost-effective...

Position:Case Manager In HospitalPosition Purpose:To coordinate care in allocated facilities, in order to improve health outcomes and manage the cost to the Scheme(/s). The case manager's responsibilities start from patient admission to discharge and they should have an understanding of hospital processes and the importance of making cost-effective...

The successful candidate will be responsible for liaising between the patients, treating clinicians, and managed care organisations to provide an accurate clinical motivation /indication of the patient’s stay in hospital.The Case Manager will also assume responsibility for the application of clinical knowledge in the risk management of...

Full Time _Johannesburg_ November 6, 2023 - December 6, 2023 Management - Medical Nursing **Job Overview**: **Requirements**: - Registered with SANC - as a Registered Nurse / Enrolled Nurse - 4 - 5 years’ working with finance and Medical Aid Administration - Experience working within a Hospital will be an advantage - Advanced Computer Literacy - Clinical...

Company Description **About Kaelo** Kaelo provides essential healthcare solutions ensuring the physical and psychosocial well-being of all South Africans towards lasting social change. Insurance products with limited medical benefit need close supervision for casualty and admission cases. **Job Description**: Load all hospital related cases for casualty...

Role Title: Case Manager Role Summary: Are you a healthcare professional looking to make a significant impact in patient care and financial risk management? If so, we have an exciting opportunity for you to join the team of a private hospital based in Gauteng as a Case Manager. In this role, you will leverage your clinical knowledge and expertise to ensure...

Case Manager is responsible for developing and implementing intensive multifaceted risk management interventions on a patient-specific basis with the purpose of preventing or reducing the medical schemes’ exposure to potentially high cost members(in/out of hospital) who have been identified and risk stratified through claims analyses and clinical criteria....

**Qualifications**: Enrolled/ Registered Nurse Valid registration with SANC **Skills and Competencies Required**: 3 to 5 years experience within a managed healthcare or medical scheme environment Solid understanding of value-based care Demonstrated ability to manage a portfolio of hospital cases Outcome focused with the ability to manage competing...

The Case Manager is responsible to act as the liaison and care co-ordinator between the patient and various healthcare providers, including physicians, nurses, therapists, social workers, other specialists, family members and the funders to ensure high-quality care and rehabilitation services that supports person-centred health and care, promoting positive...

**Location: Clinix Botshelong-Empilweni Private Hospital (Vosloorus).** **Reports to: Patient Services Manager.** **Job Summary**: To plan, coordinate and execute case management work at hospital level. The incumbent utilises clinical knowledge to minimise financial risk and ensure accurate billing through comprehensive accurate coding of patient...

**20th June, 2023**: **Responsibilities**: - Ensure appropriate, complete and relevant diagnostic and procedural coding of all patient records within the hospital. - Application of clinical knowledge for effective ICD 10 and CCSA coding of patient Events. - Clinical coding of all patient events with valid ICD 10 and CCSA codes relevant to diagnosis,...

**Case Manager** **About** One of the largest private Medical Aid companies in SA. They have been established for 20 years and are striving to be #1 in SA. **Duties and responsibilities** Delivering of cost-effective managed healthcare service to accomplish member satisfaction. - Case management of authorised cases according to the acceptable Scheme...

**Case Manager** **About** One of the largest private Medical Aid companies in SA. They have been established for 20 years and are striving to be #1 in SA. **Purpose** Delivering of cost-effective managed healthcare service to accomplish member satisfaction **Duties and responsibilities** Delivering of cost-effective managed healthcare service to...

Full Time _Gauteng_, _Randfontein_ April 22, 2024 - May 22, 2024 Manager - Medical & Optometry **Job Overview**: **Requirements**: - B degree/diploma nursing qualification and/or Case Management qualification - Diverse clinical nursing experience - Case Management experience - ICD-10 / CPT coding qualification or experience - SAP IS-H experience -...

Our client, who is in the Health Care Industry, has a vacancy for a Case Manager on a Permanent basis The Case Manager will have thorough, well-grounded clinical knowledge of hospital admissions, LOS and LOC Excellent knowledge of the South African Healthcare industry and prevailing legislation, current coding structures i.e., ICD10's, CPT4, NRPL, PMB...

A reputable Medical Aid is seeking a Nurse who has experience within the Medical Aid environment, to join their HBM Case Management team. **Duties**: - Providing clinical knowledge of hospital pre-authorisation and Case Management of hospital cases in order to take cost effective and appropriate decisions in evaluating treatment, LOS and...

**Requirements**: Qualified Registered Nurse A qualified EN with relevant experience would be considered Both need to registered with SANC and proof of indemnity cover Minimum 3 years nursing experience in a multidisciplinary hospital. Experience and exposure in Theatre and/or ICU would be advantageous Hospital or Medical Aid scheme case management would be...

To ensure clinical appropriateness of care at lowest possible cost without compromising quality of care. To use appropriate tools such as Burden of Care Criteria in the application of discharge planning. To manage the risk to the client by assessing the quality of information received and sent out and anticipating the cost for the scheme. To recognize the...

To ensure clinical appropriateness of care at lowest possible cost without compromising quality of care. To use appropriate tools such as Burden of Care Criteria in the application of discharge planning. To manage the risk to the client by assessing the quality of information received and sent out and anticipating the cost for the scheme. To recognize the...