Overview
Hospital Case Manager – Mediclinic George, George, South Africa
Closing date: 04/11/2025
Number of positions: 1
Recruiter name: Dalena Boshoff
Reference number: 64940
Workplace Type: On-site
Permanent
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 minimise the financial risk for the organisation
Key responsibilities
Minimise financial risk by effectively managing patient stay
Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems
Ensure correct and timeous finalisation of cases to facilitate reimbursements from funders of claims
Consistently and timeously communicate with Funders as contractually agreed through the relevant case management channels
Ensure clinical coding standards are adhered to as per Level 3 coding guideline
Lead and manage the people in the Case Management team (if applicable)
Required Education
ESSENTIAL EDUCATION: Registered Nurse / Professional Nurse
DESIRED EDUCATION: Clinical qualification
Required Experience
ESSENTIAL MINIMUM EXPERIENCE: Minimum of 3 years in a clinical role
DESIRED EXPERIENCE: Experience in Theatre and/or ICU; Medical aid background; Experience in private healthcare environment
Required Job Skills And Knowledge
Understanding of anatomy; physiology and medical terminology
Funder Contracts; Medical aid requirements/narrations
Scientific nursing principles and process
Authorisation and motivation of Level of Care; Length of Stay; Clinical Coding, high-cost stock, Short Payments etc.
Use of electronic systems (i.e. B2B or Funder portals) for the purposes of requesting authorisations, performing case management updates and for troubleshooting
Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.)
Daily workflow; managing deviances; clinical coding; and case management processes
Application of clinical codes and finalisation thereof
All applicants will be considered, with the understanding that preference will be given in accordance with the Employment Equity Plan of Mediclinic Southern Africa, as well as internal applicants/employees that meet the minimum requirements.
EEO statement: Mediclinic is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.