Case Manager – Registered Nurse (Full-time)

About the role

A case manager coordinates, plans, and oversees services to support individuals navigating complex medical, social, or financial systems.

Key responsibilities

• Assess patient conditions and develop appropriate care plans.
• Interact with patients and medical aid schemes to resolve queries.
• Obtain doctors' letters, motivations and justifications required by medical aid schemes.
• Monitor patient admissions, identifying limitations imposed by managed-care or medical-aid structures.
• Maintain a control system for systematic monitoring of managed-care patients.
• Handle patient queries and update hospital information accurately.

Required profile

• Qualified Registered Nurse with a minimum of 3 years nursing experience in a multidisciplinary hospital.
• Experience in Theatre and/or ICU is advantageous.
• Experience in hospital or medical-aid scheme case management is a plus.
• Proficiency in ICD-10 and CPT coding is essential.
• Knowledge of Prescribed Minimum Benefits (PMB) scheme rules and policies.
• Excellent communication, analytical and problem-solving abilities, with strong attention to detail.

Required skills

• ICD-10 coding
• CPT coding
• Microsoft Outlook
• Microsoft Word
• Microsoft Excel
• Kronos
• Clinic Manager