Senior Case Manager - Polokwane, South Africa - Select One

Select One

Verified Company

Polokwane, South Africa

1 week ago

Posted by:

Thabo Mthembu

beBee Recruiter

Description

Role summary:

The Case Manager will be responsible for the financial risk management of all patients according to managed healthcare policies in terms of length of stay, level of care and available benefits.

The incumbent will be responsible for liaising between the patients, treating clinicians and medical aids in order to provide and submit accurate accounts of the patients stay in hospital for reimbursement.

Requirements:

Education

Minimum Grade 12 Qualification
Certification in ICD 10 and CPT 4 coding
Enrolled Nursing qualification or equivalent NQF Level 4 desired
Computer proficiency in MS Office suite (Word, Excel, Outlook and PowerPoint) academic checks will be performed to verify certificates and qualifications
Intensive Care Nursing experience will add as an advantage
Medical background experience or exposure will be an advantage

Work experience

Private Hospital Case Management compulsory, minimum 3 years in multidisciplinary environment
Must come from a
multidisciplinary acute care hospital with experience in the following disciplines:
ICU
Neonatal
Surgical with focus on Ophthalmology, Orthopaedic, General Surgery
Medical with focus on Physiotherapist
Acute admissions such as Pneumonia, Diabetes
Emergency case management
A working knowledge of the hospital HIMS or related software will be an advantage
Demonstrative sound knowledge and experience of DRGs and various fee structures
Financial acumen with experience in financial and statistical analysis would be an advantage