Hospital Case Manager

Mediclinic International; Bloemfontein; On-site; ZAR 30 000 - 60 000; Full time

Job summary

Join a forward-thinking healthcare provider where you will play a critical role in coordinating hospital case management. This position involves facilitating communication among all stakeholders and ensuring compliance with case management procedures. Ideal candidates will have a nursing or paramedic background, with at least three years of clinical experience. You will lead a team to ensure timely finalization of cases and adherence to clinical coding standards, all while contributing to the financial well-being of the organization. If you are passionate about making a difference in healthcare, this opportunity is for you.

Qualifications

• Minimum of 3 years in a clinical role required.
• Experience in Theatre and/or ICU preferred.

Responsibilities

• Coordinate hospital case management processes.
• Manage patient stays to minimize financial risk.

Skills

Anatomy

Funder Contracts

Patient admin programmes on the AS400 system

Scientific nursing principles

Clinical coding standards

Daily workflow management

Education

Registered Nurse

Professional Nurse

Qualified Paramedic

Job description

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Closing date: 15/05/2025
Number of positions: 1
Recruiter name: Daniel Gert Andries Van Der Westhuizen
Reference number: 60138
Workplace Type: On-site
Employment type: 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 THE JOB

To coordinate the hospital case management process and facilitate communication between all role players by providing accurate and timely clinical information to minimise the financial risk for the organisation.

KEY RESPONSIBILITY AREAS

• Minimise financial risk by effectively managing patient stays
• Ensure compliance with case management procedures, contracts, and legal requirements by utilising available resources and systems
• Ensure correct and timely finalisation of cases to facilitate reimbursements from funders
• Communicate consistently and promptly with funders as per contractual agreements through the relevant channels
• Ensure adherence to clinical coding standards as per Level 3 coding guidelines
• Lead and manage the Case Management team (if applicable)

REQUIRED EDUCATION

Desired Education: Registered Nurse / Professional Nurse or qualified Paramedic

REQUIRED EXPERIENCE

Essential Minimum Experience: Minimum of 3 years in a clinical role

Desired Experience: Experience in Theatre and/or ICU; Medical aid background; Experience in private healthcare or as an ILS/ALS Paramedic

REQUIRED JOB SKILLS AND KNOWLEDGE

• Anatomy (including terminology)
• Funder Contracts; Medical aid requirements/narrations
• Patient admin programmes on the AS400 system
• Scientific nursing principles and processes
• Authorisation and motivation of Level of Care; Length of Stay; Short Payments, etc.
• Relevant statutory acts (e.g., Consumer Protection Act; PMB; etc.)
• Patient Administration policies and procedures (e.g., Confidentiality; Visitation policies)
• Daily workflow management; managing deviations; coding; and case management processes
• Application of clinical codes and finalisation (Level 3 coding)

All applicants will be considered, with preference given in accordance with the Employment Equity Plan of Mediclinic Southern Africa, including internal applicants/employees meeting the minimum requirements.

Note: Internal employees on fixed-term contracts should apply using an external candidate profile.

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