Case Manager – Specialized Units

About the role

The Case Manager – Specialized Units will work at Life Cosmos Hospital, Mpumalanga, reporting to the Patient Services Manager. The role focuses on managing financial and clinical administrative risks for patients in intensive, high‑care and neonatal intensive care units.

Key responsibilities

• Conduct ward rounds and collect complete clinical data from patient files.
• Update clinical information to justify length of stay and level of care for funders.
• Communicate funder requirements and responses to clinicians and patients.
• Manage real‑time and manual messaging, including requests, responses, rejections and submissions.
• Ensure accurate submission of accounts and coding of patient records.
• Apply and interpret RSRT contracts and fee‑for‑service claims correctly.
• Report identified risks and incidents, adhering to escalation processes.
• Build and maintain relationships with internal and external stakeholders, providing training and feedback on RSRT contracts.

Required profile

• Diploma or degree in Nursing, Physiotherapy, Clinical Associates or Paramedics.
• Experience working in intensive care, high‑care or neonatal intensive care environments.
• Knowledge of managed‑care funder contracts, RSRT agreements and medical billing processes.
• Ability to collect, analyse and present clinical data accurately.
• Strong understanding of governance, risk management and service level agreements.

Required skills