Hospital Case Manager

Mediclinic International; Parow; On-site; ZAR 200 000 - 300 000; Full time

Job summary

A leading healthcare provider in Parow is seeking a Case Manager to coordinate the hospital case management process and facilitate communication among all role players. The successful candidate will be responsible for managing patient stays to minimize financial risk for the organization. A background as a Registered Nurse or qualified Paramedic with at least three years of clinical experience is required. Applicants must demonstrate compliance with case management procedures and effective communication with funders.

Qualifications

• Minimum of 3 years in a clinical role.
• Experience in Theatre and/or ICU; Medical aid background.
• Experience in a private healthcare environment or as an ILS/ALS Paramedic.

Responsibilities

• Coordinate the hospital case management process.
• Minimise financial risk by effectively managing patient stay.
• Ensure compliance to case management procedures and contacts.
• Communicate with Funders as contractually agreed.

Skills

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

Relevant aspects of applicable statutory acts

Patient Administration policies and procedures

Daily workflow; managing deviances; coding

Application of clinical codes

Education

Registered Nurse / Professional Nurse or qualified Paramedic

Job description

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Mediclinic Panorama| Panorama, Cape Town | South Africa

Closing date: 19/01/2026
Number of positions: 1
Recruiter name: Magdalena Van Der Walt
Reference number: 66188
Workplace Type:On-site
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 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.

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

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