Case Manager - Isipingo

Joint Medical Holdings; KwaZulu-Natal; On-site; ZAR 300,000 - 460,000; Full time

Job summary

Joint Medical Holdings Isipingo Hospital seeks a Case Manager to advocate for patients, streamline processes, and optimize healthcare resources for better outcomes.

Must hold a nursing qualification with SANC registration. Experience with ICD-10/CCSA coding is required; billing experience is advantageous. Liaising with medical aids, doctors and patients is essential to support a multidisciplinary hospital team.

Qualifications

• Registered with SANC as a nurse.
• Experience with ICD-10 and CCSA coding is required.
• Billing/auditing experience will be advantageous.
• Experience in a multidisciplinary hospital environment.
• Experience liaising with medical aids, doctors and patients.

Responsibilities

• Adhere to policy and SLA for clinical updates and turnaround times.
• Ensure precise ICD-10/CCSA coding and accurate billing.
• Communicate with medical schemes and healthcare providers.
• Manage DSO and optimize related tools.
• Oversee Care Risk Management procedures and protocols.
• Resolve case management rejections and promote teamwork.
• Stay updated on industry trends and relevant guidelines.

Skills

Attention to detail

Computer skills

Teamwork

Under pressure

Education

Nursing qualification - SANC registered

Tools

ICD-10 coding

CCSA coding

Billing tools

Job description

DIVISION:ISIPINGO HOSPITAL

JOB TITLE:CASE MANAGER

PURPOSE OF POSITION

As a Case Manager, you will advocate for patients, optimize healthcare resources, and promote positive outcomes. Your expertise will streamline processes, enhance patient satisfaction, and contribute to the overall effectiveness of JMH healthcare delivery system.

KEY PERFORMANCE AREAS

• Adhering to JMH policy regarding clinical updates within specified turnaround times and service level agreements.
• Ensuring precise and comprehensive ICD 10/CCSA coding.
• Meeting month-end deadlines.
• Verifying accurate and complete billing.
• Communicating adequate and pertinent information to medical schemes.
• Managing internal DSO and optimizing utilized tools.
• Overseeing the complete rollout and adherence to Care Risk Management Procedures and Protocols.
• Effectively resolving rejections related to case management.
• Cultivating a collaborative and supportive workplace atmosphere, encouraging teamwork, communication, and professional growth among team members.
• Keeping abreast of industry trends, regulations, and best practices in case management, ensuring compliance with relevant standards and guidelines.

REQUIREMENTS A COMPETENCES

MINIMUM REQUIREMENTS

(Educational Qualifications & Experience)

• Relevant Nursing Qualification - Registration with the SANC
• computer literate.
• Must have Billing / Auditing experience will be advantageous.
• Experience in a multidisciplinary hospital environment.
• ICD 10 and CCSA coding experience is a requirement.
• Must have experience in liaising with medical aids, doctors, and patients.

SKILLS AND COMPETENCIES

(Practical & Technical)

• Excellent attention to detail
• Excellent computer skills
• Ability to work well within a team
• Ability to work in a pressurised environment

BEHAVIOURAL ATTRIBUTES

(Personality Characteristics)

• Communication and problem-solving skills. Adaptable, customer-focused, and capable of working well in a team. Attention to detail, empathy, and professionalism are also crucial attributes. Additionally, organizational skills and a commitment to continuous improvement are essential for ensuring smooth operations and providing excellent service to patients and visitors.

JMH VALUES

(Commitment)

• Respect for Individual Dignity: We uphold the dignity of every individual.
• Excellence in Service to Doctors: We ensure top-quality service delivery to our physicians through efficient processes, clear communication, and proactive support, meeting their needs and exceeding expectations.
• Trust and Development: We aim to nurture trust among our team members and offer training and growth opportunities to help them realise their maximum potential.

Join our team at Isipingo Hospital and contribute to our mission of providing exceptional care to our patients and community.

NB: Only short-listed candidates will be contacted.

POPIA CLAUSE

Your information is collected and processed in accordance with the Protection of Personal Information Act No 4 of 2013 (POPIA).

By applying to this advert, you consent to JMH (Pty) Ltd collecting and processing your personal information for the purpose of determining your eligibility for the advertised position.