Hospital Case Manager

Joint Medical Holdings Ltd.; KwaZulu-Natal; On-site; ZAR 300,000 - 400,000; Full time

Job summary

A healthcare organization in KwaZulu-Natal seeks a Case Manager to advocate for patients and optimize healthcare resources. You'll ensure precise coding, manage billing processes, and promote patient satisfaction while adhering to hospital protocols. A relevant nursing qualification and experience in a hospital environment are essential. The role emphasizes teamwork, communication, and a commitment to best practices in healthcare delivery.

Qualifications

• Nursing qualification with registration with the SANC is essential.
• Experience in a multidisciplinary hospital environment is required.
• ICD 10 and CCSA coding proficiency is a must.

Responsibilities

• Advocate for patients and streamline healthcare processes.
• Verify accurate billing and communicate with medical schemes.
• Manage internal DSO and implement Care Risk Management protocols.

Skills

Healthcare advocacy

ICD 10 and CCSA coding

Communication

Teamwork

Billing/Auditing

Education

Relevant Nursing Qualification

Job description

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.

COMPETENCIES (The following will be advantageous)

MINIMUM REQUIREMENTS

(Educational Qualifications & Experience)

• Relevant Nursing Qualification withRegistration with the SANC
• Must be 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.