Case Manager – Trainee (KZN)

Administration

The Case Manager will be responsible for the liaison between the patient and medical aids in order to secure payment for the hospital. NOTE this position involves some travel between the KZN hospitals following the completion of training. 

• Grade 12 or equivalent NQF level 4 qualification
• Diploma in Nursing Qualification is essential
• ICD & CPT Coding certificate – will be included in the next training intake

• Previous Case Management experience will be advantageous, but not required for this trainee position
• Intermediate computer skill (Excel and Word)
• Excellent Interpersonal and communication skills

• Training will be provided on all these knowledge areas below.
• 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
• Arrange in-service training for relevant staff to meet the needs of the theatre department
• Liaise network of internal and external stakeholders to ensure that managed care of patients is maintained
• Actively participate as a member of a team to achieve goals
• Active involvement in own professional development to maintain a satisfactory level of skill and knowledge
• Work effectively and co-operatively with others to establish and maintain good working relationships that are mutually beneficial.
• Develop collaborative relationships to help accomplish work goals
• Manage the Group Debtors Age Analysis rejections from funders with the Hospital Case Management Teams