Wednesday , February 28 2024

Mediclinic Vacancies 2023 – Hospital Case Manager

Website Mediclinic Legae

Job Description:

To coordinate the hospital case management process and facilitate the communication process between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation.

Job Responsibilities:

  • Lead and manage the people in the Case Management team (if applicable)
  • Ensure correct and timeous finalisation of cases to facilitate reimbursements from funders of claims
  • Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems
  • Minimise financial risk by effectively managing patient stay
  • Ensure clinical coding standards are adhered to as per Level 3 coding guideline
  • Consistently and timeously communicate with Funders as contractually agreed through the relevant case management channels

Job Requirements:

  • Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.)
  • Authorisation and motivation of Level of Care; Length of Stay; Short Payments etc.
  • Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.)
  • Application of clinical codes and finalisation thereof (Level 3 coding)
  • Patient admin programmes on the AS400 system
  • Funder Contracts; Medical aid requirements/narrations
  • Daily workflow; managing deviances; coding; and case management processes

Qualification & Experience:

  • Registered Nurse / Professional Nurse or qualified Paramedic
  • Experience in Theatre and or ICU; Medical aid background;
  • Experience in private healthcare environment or experience as an ILS/ALS Paramedic
  • Clinical qualification
  • Minimum of 3 years in a clinical role

Job Details:

Company: Mediclinic Legae

Vacancy Type: Full Time

Job Location: Pretoria, Gauteng, South Africa

Application Deadline: N/A

Apply Here