Case Manager - Isipingo

Joint Medical Holdings; KwaZulu-Natal; On-site; ZAR 420,000 - 660,000; Full time

Job summary

Joint Medical Holdings invites applications for a Case Manager at Isipingo Hospital. The role advocates for patients, optimizes resources, and streamlines processes to improve outcomes across the care continuum.

You will drive accurate coding (ICD-10/CCSA) and ensure effective communication with medical aids, doctors and patients. Required is a SANC-registered nurse with solid computer skills and hospital experience.

Qualifications

• SANC registered nurse with a nursing qualification.
• Computer literate.
• Billing / Auditing experience is advantageous.
• Experience in a multidisciplinary hospital environment.
• ICD 10 and CCSA coding experience is a requirement.
• Experience liaising with medical aids, doctors and patients.

Responsibilities

• Adhere to policy regarding clinical updates within specified turnaround times and service level agreements.
• Ensure precise and comprehensive ICD 10/CCSA coding.
• Meet month-end deadlines.
• Verify accurate and complete billing.
• Communicate adequate and pertinent information to medical schemes.
• Manage internal DSO and optimize utilized tools.
• Oversee the rollout and adherence to Care Risk Management Procedures and Protocols.
• Resolve rejections related to case management.
• Cultivate a collaborative and supportive workplace atmosphere and encourage teamwork.
• Keep abreast of industry trends, regulations, and best practices in case management.

Skills

Nursing qualification

SANC registration

Billing experience

ICD-10 coding

CCSA coding

Multidisciplinary work

Communication skills

Teamwork

Education

Nursing qualification with SANC registration

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.

Minimum Requirements

REQUIREMENTS A COMPETENCES

(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. Make a difference in healthcare delivery.

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.