Case Manager | General Units | Short Term | Fixed Term Contract

Case Manager | General Units | Short Term | Fixed Term Contract

Function: Patient Services | Facility: Life Vincent Pallotti Hospital

Position: Case Manager | General Units | Short Term | Fixed Term Contract

Introduction:

A vacancy exists for a Case Manager, General Units, based at Life Vincent Pallotti Hospital, reporting to the Patient Services Manager, Ester van der Walt. The successful candidate will be responsible for managing the financial and clinical administrative risks related to patients in St Vincent’s and the General Units. This is a Fixed Term Contract (short-term).

Critical Outputs

Ensuring operational excellence by:

• Conducting ward rounds and ensuring accurate collection of clinical data from patient files, liaising with nursing staff and clinicians.
• Updating clinical information to justify length of stay and level of care for medical funds, including specialised and general ward cases.
• Providing funders with necessary information regarding high-value items, benefits, and protocols as defined by managed care organizations.
• Communicating funder requirements and responses to clinicians and patients, ensuring industry standards compliance.
• Managing real-time and manual messaging effectively, including requests, responses, rejections, and submissions.
• Submitting accounts accurately to funders.
• Adhering to governance and risk management policies and procedures.
• Meeting service level agreements with stakeholders.

Ensuring effective management of revenue:

• Accurate and complete coding of patient accounts.
• Correct application and interpretation of RSRT contracts and FFS claims.
• Reporting RSRT risks to the relevant manager.

Ensuring effective management of quality outputs:

• Following escalation processes and customer service standards.
• Investigating and reporting incidents and alerts, and coordinating appropriate actions.

Managing relationships with stakeholders:

• Building and maintaining internal relationships.
• Providing training on RSRT contracts.
• Providing feedback on external stakeholder concerns and issues.
• Reporting non-compliance issues to RSRT meetings.

Requirements:

• Nursing qualification; Registered Nurse with at least five years’ experience.
• Experience as a Case Manager is highly advantageous.
• Proven leadership, change, and people management skills.
• Current registration with the relevant professional body.
• Knowledge of clinical coding, terminology, anatomy, and funder rules.
• Working knowledge of COID.
• Understanding of business and change management principles.
• Computer proficiency.

Competencies:

• Problem-solving, analysis, and judgment.
• Resilience.
• Engaging diversity.
• Effective communication and presentation skills.
• Influencing skills.
• Drive and energy.
• Orientation towards excellence.
• Ethical behavior.
• Relationship building.
• Customer responsiveness.
• Organizational awareness.
• Leading by example (Key for Managers).
• Motivating and developing people (Key for Managers).

Interested candidates should email debra.choice@lifehealthcare.co.za. Closing date: Sunday, April 27, 2025.

Internal applicants are encouraged to discuss their application with their line manager before applying. External candidates will also be considered.

Life Healthcare is an Equal Opportunity Employer. Only shortlisted candidates will be contacted. If you haven't heard within two weeks of the closing date, please consider your application unsuccessful.