Hospital Benefit Specialist - RN Care Coordination

Discovery Limited; Milnerton; On-site; ZAR 420,000 - 660,000; Full time

Job summary

Discovery Health, a subsidiary of Discovery Limited, is seeking a Hospital Benefit Specialist in Cape Town. The role involves assessing clinical history, service levels, and facility appropriateness to approve or decline funding for member care.

You will communicate decisions to providers and members, manage information requests, and assist with discharge planning and clinical reviews. Travel up to 50km may be required in the course of duties.

Qualifications

• Matric and valid nursing registration (SANC) are essential.
• Minimum 3 years clinical experience in a private hospital setting (ICU/Trauma/Medical).
• Minimum 2 years managed health care experience.
• Proficient in Microsoft Excel for reporting and data management.

Responsibilities

• Assess cases, clinical history, and level of care to determine funding approvals.
• Communicate decisions and required information to providers and members.
• Coordinate discharge planning and alternatives to ensure appropriate care levels.
• Support clinical review processes and trend analysis for process improvement.

Skills

Communication

Education

Matric

Registered Nurse (RN)

SANC Registration

Tools

Excel

Job description

Discovery Health, a subsidiary of Discovery Limited, is seeking a Hospital Benefit Specialist in Cape Town. The role involves assessing clinical history, service levels, and facility appropriateness to approve or decline funding for member care.

You will communicate decisions to providers and members, manage information requests, and assist with discharge planning and clinical reviews. Travel up to 50km may be required in the course of duties.