Overview
Hospital Case Manager Jobs in Johannesburg, South Africa at Mediclinic
Wits Donald Gordon Med Centre | Parktown, Johannesburg | South Africa
Closing date: 10/02/2025
Number of positions: 1
Recruiter name:
Masego Patricia Katane
Reference number: 57412
Workplace Type:
On-site
Permanent
Please note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profile
MAINPURPOSEOF JOB
To coordinate the hospital case management process and facilitate thecommunicationprocess between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation.
KEY RESPONSIBILITY AREAS
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
DESIREDEDUCATION:Registered Nurse / Professional Nurse or qualified Paramedic
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 or experience as an ILS/ALS Paramedic
REQUIRED JOB SKILLS AND KNOWLEDGE
Anatomy; physiology and terminology
Funder Contracts;
Medical aid requirements/narrations
Scientific nursing principles and process
B2B EMS (electronic message system: check status of authorisations and use for troubleshooting)
Authorisation and motivation of Level of Care;
Length of Stay;
Short Payments etc.
Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.)
Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.)
Daily workflow; managing deviances; coding; and case management processes
Application of clinical codes and finalisation thereof (Level 3 coding)
Patient admin programmes on the AS400 system
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.
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Title: Hospital Case Manager
Company: Mediclinic
Location: Johannesburg, South Africa
Category: Healthcare
