Job Description

Our client, a leader in the medical industry, is currently looking for Case Manager (RN)/(PN) - Corporate Support in Stellenbosch in the Western Cape. This is a permanent position. This is a hybrid positionBENEFITS

• Thirteenth cheque
• Pension fund membership and subsidy from the company
• Medical aid membership and subsidy from the company
• Complimentary indemnity cover

Requirements

• Registered with the South African Nursing Council as a Registered Nurse
• Experience in Theatre and/or ICU will serve as an advantage
• Experience in the private healthcare environment will serve as an advantage
• Medical aid background will serve as an advantage
• Case management experience is essential
• Anatomy; physiology and terminology
• Application and validation of clinical codes (Level 3 coding)
• Authorisation and motivation of Level of Care; Length of Stay; Short Payments etc.
• B2B EMS (Electronic message system: check status of authorisations and use for trouble-shooting)
• Computer literacy (e.g. Outlook and intranet applications)
• Daily Workflow, Managing deviances, Coding, and Case Management processes
• Funder Contracts; Medical aid requirements/narrations
• Patient Administration policies and procedures (Patient Confidentiality, Visitation of external case managers, etc.)
• Proficient all relevant Patient Admin systems and programs
• Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB, etc.)
• Scientific Nursing Processes and associated procedures

Key OutputsMAIN PURPOSE OF JOBTo support the hospital in the absence of hospital Case Managers and to facilitate the communication process between all role players by providing accurate and timeous clinical information to minimiseKEY RESPONSIBILITY AREAS * Minimise financial risk by effectively managing patient stay

• Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems
• Ensure correct and timeous finalisation of cases, and consistently and timeously communicate with Funders to facilitate reimbursement of claims

Employment Conditions

• Competitive pay rates
• Flexible payment options
• Placement opportunities at various clients across South Africa
• Complimentary indemnity cover at specified clients

Other InformationIf you are interested in this opportunity and meet the requirements, apply directly by clicking on Apply. Kindly ensure that your profile is complete and up to date. For any online support, please contact our Career Centre:

• Free State, KwaZulu-Natal, Northern and Western Cape: T 0219436270 / talent@mhr.co.za
• Gauteng, Limpopo, Mpumalanga and North West: T 0219436269 / careers@mhr.co.za

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