Case Manager - Hospital

About the role

A hospital in the Lowveld is looking for a Case Manager within its Case Management department. The main purpose of the role is to liaise between patients and medical aids so that the hospital can secure payment for services provided.

Key responsibilities

• Keep the billing system accurate and up to date, and supply patient history details to clinical partners
• Monitor and control costs for Managed Care Organisation patients, confirm their length of stay and ensure correct coding
• Assist with final authorisation of Managed Care patient files and accompany their case managers on ward rounds
• Consult service providers about patient care treatment and assist with transfers to rehab hospitals or step-down facilities
• Liaise with internal and external stakeholders to maintain managed care, and arrange in-service training for staff to meet the needs of the theatre department
• Work as part of a team, develop collaborative relationships and take part in your own professional development

Required profile

• Grade 12 or equivalent NQF level 4 qualification
• Diploma in Nursing is essential
• Previous case management experience is advantageous; knowledge of medical aids and ICD and CPT coding is also advantageous
• Excellent interpersonal and communication skills