Case Management Team Lead- Port Elizabeth

Mvgrecruitment; Oos-Kaap; On-site; ZAR 700,000 - 900,000; Full time

Job summary

Mvgrecruitment is supporting a leading healthcare organisation in Port Elizabeth to recruit an experienced Case Manager/Clinical Risk to lead a pivotal hospital risk management team. The role requires nursing registration, advanced case management experience, and strong ICD-10 auditing skills.

You will supervise clinical teams, drive audits, and mentor staff while ensuring scheme compliance and quality across operations in a hospital setting.

Qualifications

• Registered nurse with SANC status and essential nursing degree/diploma.
• Strong ICD-10 coding knowledge and clinical auditing experience.
• Proven track record in managing and training clinical teams.
• Experience in managed care/case management and private hospital settings.
• Proficient in MS 365 and related collaboration tools.
• National Senior Certificate and nursing qualification are mandatory.

Responsibilities

• Lead Case Management and Clinical Audit teams to meet KPIs.
• Auditing and audit preparation to ensure compliance and quality.
• Provide training and mentorship on ICD-10 coding, scheme rules, and compliance.
• Resolve complex case management and audit queries with oversight.
• Monitor and report operational performance; drive continuous improvement.
• Ensure adherence to HR policies, quality standards, and stakeholder requirements.

Skills

Nursing

ICD-10 coding

Clinical auditing

Team leadership

Training & mentorship

Education

National Senior Certificate

General Nursing Diploma/Degree

Tools

MS 365

Job description

A leading healthcare organisation in Port Elizabeth is seeking an experienced Case Manager/Clinical Risk to step into a pivotal team leadership role within Hospital Risk Management.

Key Requirements:

• National Senior Certificate plus General Nursing Diploma/Degree
• Current registration with SANC as a Professional Nurse
• Minimum 3 years’ experience in managed care/case management
• Minimum 3 years’ clinical experience in a private hospital (ICU/theatre advantageous)
• Strong knowledge of ICD‑10 coding and clinical auditing
• Proven experience managing, supervising, and training clinical teams
• Solid understanding of the medical scheme industry
• MS 365 proficiency

Responsibilities:

• Lead and support Case Management and Clinical Audit teams to achieve KPIs
• Auditing and auditing preparation
• Provide training and mentorship to staff on ICD‑10 coding, scheme rules, and compliance
• Resolve complex case management and audit queries
• Monitor and report on operational performance, driving continuous improvement
• Ensure compliance with HR policies, quality standards, and stakeholder requirements