Case Manager – Hospital Group – Mafikeng

About the role

Deliver an effective case management process and facilitate communication between all role‑players by providing accurate and timely clinical information, thereby minimizing financial risk for the hospital group.

Key responsibilities

• Ensure daily admission authorizations are accurate in the SAP system.
• Conduct daily case management rounds in allocated units to obtain updated clinical information.
• Follow case management procedures, medical scheme contracts and legal requirements using the Case Manager Workstation on SAP.
• Communicate promptly with medical schemes through established case management channels.
• Obtain doctors' letters of motivation when required by medical schemes.
• Minimize financial risk by effectively managing patient stays.
• Provide daily statistics to Billing and work to progress files toward discharge and final billing.
• Resolve short‑payment queries in collaboration with the Collections Department.

Required profile

• Grade 12 qualification.
• Registered Nurse, currently registered with the South African Nursing Council (SANC).
• Certificate in Coding (advantageous).
• 3–5 years’ experience in a private hospital or medical scheme environment in a case management capacity.
• Working knowledge of ICD‑10 and CPT codes.
• Computer proficiency, preferably with SAP or similar systems.

Required skills

• ICD‑10 coding.
• CPT coding.
• Proficiency with SAP system.
• General computer proficiency.