Case Manager (Nursing)

SUMMARY:

Duties & Responsibilities include:

(But are not limited to)

• Assess patient conditions and needs to develop appropriate care plans
• Interact with patients and medical aid schemes
• Resolve patient and medical aid scheme queries
• Update all information timeously and accurately
• CPT and ICD coding
• Obtain doctors letters, motivations, and justifications in all appropriate cases under managed care of where medical aids request them from their hospitals as part of their assessing process
• Monitor patient admissions and identify those who have limitations, restrictions, place by their managed care/ medical aid structures e.g. length of stay, cost restrictions, fixed fees, per diem and other limiting fees or drugs and/ or formularies
• Maintain a control system that ensures the systematic monitoring of managed care patients
• Handling patient queries
• Update hospital information

POSITION INFO:

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 an advantage
• Experience in ICD 10 and CPT coding is essential
• Knowledge of Prescribed Minimum Benefits (PMB) Scheme rules and policies
• Excellent communication skills (written and spoken)
• Excellent analytical and problem-solving skills
• Excellent MS Office computer skills, i.e. Outlook, Word, Excel, Kronos, Clinic Manager, etc.
• Attention to detail
• Ability to cope well under pressure

Should you meet the above requirements, we urge you to please apply by forwarding your CV along with any supporting documents to --------Please upload your CV here-------->

Contact will only be made with shortlisted candidates. Should you not hear from us within two weeks, please consider your application unsuccessful

NB! This job is now closed. You can apply for other jobs by uploading your CV.