Case Manager: Corporate Support

Mediclinic International; Stellenbosch; Hybrid; ZAR 300 000 - 400 000; Full time

Job summary

A leading healthcare organization in Stellenbosch is seeking a Registered Nurse to manage patient stays and support effective clinical communication. The role involves minimizing financial risks for the hospital by ensuring compliance with case management procedures and facilitating timely reimbursement from Funders. Ideal candidates will have 3-5 years of nursing experience, preferably in Theatre or ICU, with strong skills in clinical terminology and administration. The position is hybrid and permanent, with preference given to internal applicants.

Qualifications

• 3-5 years in a nursing role is essential.
• Experience in Theatre and/or ICU is desired.
• Medical aid background beneficial.

Responsibilities

• Minimise financial risk by effectively managing patient stay.
• Ensure compliance to case management procedures.
• Communicate with Funders to facilitate reimbursement of claims.

Skills

Anatomy; physiology and terminology

Application and validation of clinical codes (Level 3 coding)

Computer literacy (e.g. Outlook and intranet applications)

Daily Workflow, Managing deviances, Coding, and Case Management processes

Proficient in all relevant Patient Admin systems and programs

Scientific Nursing Processes and associated procedures

Education

Registered Nurse / Professional Nurse

Job description

Mediclinic Southern Africa Corporate Office| Stellenbosch | South Africa

Closing date: 12/01/2026
Number of positions: 1
Recruiter name: Zimkhitha Wulana
Reference number: 66363
Workplace Type:Hybrid
Permanent

Please note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profile

MAIN PURPOSE OF JOB

To 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 minimise the financial risk for the organisation; and to support efficient and effective hospital cash conversion

KEY 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

REQUIRED EDUCATION

ESSENTIAL EDUCATION

DESIRED EDUCATION

• Registered Nurse / Professional Nurse

REQUIRED EXPERIENCE

ESSENTIAL MINIMUM EXPERIENCE

• 3 - 5 years in a nursing role

DESIRED EXPERIENCE

• Experience in Theatre and/ or ICU
• Medical aid background
• Experience in the private healthcare environment

REQUIRED JOB SKILLS AND KNOWLEDGE

• 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

All applicants will be considered, with the understanding that preference will be given in accordance with the Employment Equity Plan of Mediclinic Southern Africa, as well as internal applicants/employees that meet the minimum requirements.