Overview
Hospital Care Coordinator Jobs in Johannesburg, South Africa at Kaelo
Hospital Care Coordinators are responsible for end-to-end oversight of all in-hospital cases for Kaelo clients. This includes management and coordination of care from patient admission through discharge planning. They are expected to provide daily authorization updates to ensure optimal patient care at the most effective cost. Communication with patients and providers regarding benefit availability, limitations, and review of appropriate care levels is essential.
This position reports to the Clinical Operations Manager and is supervised by the Clinical / Medical Advisor.
Note : This job specification outlines the general responsibilities and qualifications expected of a Hospital Care Coordinator. Specific duties may vary depending on the organization.
Responsibilities include :
Receive handover on cases admitted / authorized by the Acute Care Coordinators.
Coordinate care for all hospital admitted patients.
Ensure correct benefit utilization by members.
Identify exclusions from the onset of treatment requests.
Allocate the correct level of care to appropriate facilities.
Review appliances used in hospital against current treatment guidelines.
Provide information about treatment options, side effects, and possible complications of medications or procedures.
Discuss diagnoses with doctors, specialists, and healthcare providers.
Assess patient needs such as mental health or substance abuse issues and refer to EAP if applicable.
Ensure service level agreements are met.
Use the latest evidence-based guidelines for patient management.
Develop referral and treatment protocols for new or updated conditions.
Report clinical escalations or concerns to the Clinical Review Committee.
Act as a patient advocate.
Maintain confidentiality of clinical information.
Assist with monthly reporting, including statistics and savings.
Key outcomes :
Effectively utilize resources and guidelines to assess, prioritize, advise, and manage admitted patients, ensuring thorough documentation and compliance with policies.
Maintain current nursing skills through workshops, seminars, and professional development.
Qualifications :
REQUIRED
Registered Nurse
Degree / Diploma in Nursing
ICU / Theatre trained
Minimum 2 years hospital case management experience
Medical Aid or Insurance industry knowledge
Knowledge of ICD, CPT coding, and DRGs
DESIRED EXPERIENCE :
Experience in managed healthcare and hospital case management
Understanding of healthcare regulations and standards
Strong analytical and clinical decision-making skills
Effective communication with multidisciplinary teams
Technical Skills :
REQUIRED
Understanding of clinical codes
Health risk assessment knowledge
Computer literacy
Personal Attributes :
Accountability and ethical conduct
Effective communication and documentation skills
Organizational and planning skills
Resilience and adaptability
Self-development orientation
Remote Work
:
Employment Type
: [Specify if needed]
Key Skills :
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Title: Hospital Care Coordinator
Company: Kaelo
Location: Johannesburg, South Africa
Category: Healthcare (Healthcare Nursing)
