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Case Manager

Harrismith

07 Aug 2024

Case Management

The Case Manager will be responsible for the liaison between the patient and medical aids to
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

  • Grade 12 or equivalent NQF level 4 qualification
  • Diploma in Nursing or B Degree Nursing Qualification

  • Three or more years of experience in Private Healthcare
  • SAP experience will be advantageous
  • Previous experience in stock management

  • SAP system Essential
  • Intermediate computer skill
  • Knowledge of Medical Aids