Lead Healthcare Case Manager: Care Coordination

Mediclinic; George; On-site; ZAR 360,000 - 480,000; Full time

Job summary

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.

Qualifications

• 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.

Responsibilities

• 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).

Skills

Anatomy & terminology

Funder contracts

AS400 admin

Nursing science

Care authorization

Statutory acts

Patient confidentiality

Education

Registered Nurse / Professional Nurse or Paramedic

Job description

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.