Hospital Case Manager

Mediclinic; George; Presencial; ZAR 360.000 - 480.000; Jornada completa

Descripción de la vacante

Mediclinic George is seeking a Case Manager/Clinical Coordinator to oversee hospital case management, coordinating communication among role players and ensuring timely clinical information to minimise financial risk for the organisation.

Ideal candidates hold a Registered Nurse or Paramedic qualification with at least 3 years of clinical experience, and understanding of funder contracts and medical aid requirements. Willingness to work on-site is required.

Formación

• Must hold registered nursing/paramedic qualification and be eligible to practice.
• Knowledge of funder contracts and medical aid requirements.
• Experience with patient administration systems (AS400).
• Solid grounding in scientific nursing principles and processes.

Responsabilidades

• Minimise financial risk by effectively managing patient stay.
• Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems.
• Ensure correct and timeous finalisation of cases to facilitate reimbursements from funders of claims.
• Consistently and timeously communicate with Funders as contractually agreed through the relevant case management channels.
• Ensure clinical coding standards are adhered to as per Level 3 coding guideline.
• Lead and manage the people in the Case Management team (if applicable).

Conocimientos

Anatomy & terminology

Funder contracts

AS400 admin

Nursing science

Care authorization

Statutory acts

Patient confidentiality

Educación

Registered Nurse / Professional Nurse or Paramedic

Descripción del empleo

Mediclinic George| George | South Africa

Closing date: 06/11/2026
Number of positions: 1
Workplace Type:On-site
Permanent

MAIN PURPOSE OF JOB

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

KEY RESPONSIBILITY AREAS

Minimise financial risk by effectively managing patient stay

Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems

Ensure correct and timeous finalisation of cases to facilitate reimbursements from funders of claims

Consistently and timeously communicate with Funders as contractually agreed through the relevant case management channels

Ensure clinical coding standards are adhered to as per Level 3 coding guideline

Lead and manage the people in 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 environment or experience 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 process
• Authorisation and motivation of Level of Care; Length of Stay; Short Payments etc.
• Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.)
• Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.)
• Daily workflow; managing deviances; coding; and case management processes
• Application of clinical codes and finalisation thereof

All applicants will be considered, with the understanding that preference will be given in accordance with the Employment Equity Plan of Mediclinic Southern Africa, as well as internal applicants/employees that meet the minimum requirements.

Job Segment: Nursing, Registered Nurse, Case Manager, Paramedic, ICU, Healthcare