Clinical Case Manager – Kimberly
Glasshouse Recruiting · Cape Town
Job description
About the role
The Clinical Case Manager uses clinical expertise to mitigate financial risk by ensuring accurate coding of hospital events and communicating with funders to justify the level of care and length of stay. This full‑time position supports both internal teams and external medical aid providers.
Key responsibilities
- Apply clinical knowledge to justify patient hospitalisation, treatment, length of stay and level of care.
- Monitor and act on risks related to medical aid benefits and hospitalisation.
- Ensure accurate, specific, and comprehensive clinical coding (ICD‑10 / CPT).
- Communicate effectively with medical aids, reviewing authorisations and releasing cases for billing.
- Liaise with internal and external stakeholders while adhering to NHN Managed Health Care rules and relevant legislation.
Required profile
- Bachelor’s degree or diploma in Nursing and/or Case Management.
- Diverse clinical nursing experience and case‑management experience.
Required skills
- ICD‑10 and CPT coding proficiency.
- Experience with SAP IS‑H (advantageous).
- Proficiency in Microsoft Office applications.
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Published 6 days ago
Expires 1 week from now
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Glasshouse Recruiting
Cape Town
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