SUMMARY:
Integrated Care Case Manager
POSITION INFO:
At Medihelp, we live our values daily — excellence, compassion, collaboration, and transparency — to make a real difference in the lives of our members. We’re looking for someone who lives these values through their mindset, work ethic, and interactions with others.
The core purpose of the role is to identify the financial risks and impact of hospitalized members on the scheme. This is achieved by recommending funding for medical treatment at the most appropriate facility to minimize financial risk. The role also involves coordinating services between the member and the service provider to ensure proper treatment benefit allocation, aiming to prevent complications and readmissions cost-effectively.
Requirements
Grade 12, with a completed degree/diploma as a registered nurse and currently registered with the SANC.
Four years of relevant experience in Managed Healthcare or experience as a registered nurse in a hospital environment,
Key Competencies
Good verbal and written communication skills
Computer literate
Customer focus
Good negotiation and decision-making skills
Comprehensive knowledge of the Medical Scheme Act
Willing to be multi-skilled in other sections within managed care
Join a team where our values guide everything we do — from how we work together to how we serve our members.
