The Case Manager will be responsible for the liaison between the patient and medical aids tom secure payment for the hospital.
Responsibilities and Duties:
Ensure all the relevant details on Hospital Billing System are updated and are accurate
Supply all details regarding patients’ history to Clinical partners
Monitor and control costs for Managed Care Organisation patients
Confirm length of stay for all Managed Care Organisations patients
Accompany Managed Care Organisation Case Managers on ward rounds in the hospital
Assist with final authorisation of Managed Care patient files
Ensure correct coding for all Managed Care Organisation patients
Consult with the relevant service providers regarding the patient care treatment
Assist with the transfer of patients to Rehab Hospital or step-down facilities
Liaise network of internal and external stakeholders to ensure that managed care of patients is maintained
Work effectively and co-operatively with others to establish and maintain good working relationships that are mutually beneficial.Work effectively and co-operatively with others to establish and maintain good working relationships that are mutually beneficial
Grade 12/Matric
Diploma in Nursing or B Degree Nursing Qualification is essential
Three or more years of experience in Private Healthcare
