Medical Case Manager

Digicall Group; Johannesburg; On-site; ZAR 30,000 - 60,000; Full time

Job summary

An established industry player is looking for a dedicated Medical Case Manager to enhance healthcare delivery. In this role, you will provide medical expertise, manage international patient cases, and offer compassionate support to clients. Your strong clinical background and excellent communication skills will be essential in coordinating medical services and ensuring client satisfaction. Join this dynamic team and make a meaningful impact in the healthcare sector while working in a collaborative environment. If you are passionate about healthcare and thrive under pressure, this opportunity is perfect for you.

Qualifications

• Minimum 2 years’ experience in relevant field.
• Call center experience is an advantage.

Responsibilities

• Provide compassionate care and guidance to clients.
• Coordinate emergency medical services and pre-authorizations.
• Maintain accurate records of client interactions.

Skills

Clinical Background

Telephonic Communication Skills

Written Communication Skills

Multilingual

Microsoft Office Proficiency

Knowledge of Medical Aid

Knowledge of Insurance Principles

Education

Grade 12 or equivalent NQF level 4

Basic Life Support Accreditation

Job description

Role Summary

We are seeking a professional and experienced Medical Case Manager to join our team.

The purpose of this role is to provide medical expertise and to contribute towards the successful delivery of the Company’s service output. The employee will do this by performing tasks and assuming responsibilities which may include hospital pre-authorization and claims, international patient case management and medical repatriations, providing medical advice and counseling services.

If you are passionate about healthcare, possess strong administrative and communication skills, and thrive in a dynamic and collaborative environment, we encourage you to apply for this exciting opportunity.

Must be able to work shifts (day and night).

Qualifications

• Minimum: Grade 12 or equivalent NQF level 4
• Minimum: Basic Life Support accreditation / equivalent
  
  

Experience

• Minimum of 2 years’ working experience in relevant field
• Call center experience will be an advantage
• Medical and Insurance background will be an advantage
  
  

Skills & Knowledge

• Strong clinical background
• Excellent telephonic and written communication skills
• Multilingual
• Proficiency in Microsoft Office suite
• Knowledge of local medical aid and medical insurance and international patient case management principles and healthcare management
• Short-Term Insurance principles and workings
  
  

Responsibilities

• Provide compassionate, caring and friendly care and guidance to clients.
• Coordinate emergency medical services.
• Coordinate GP, emergency room and hospital pre-authorization.
• Facilitate health advisory services according to prescribed protocols.
• Facilitate counseling services according to prescribed protocols.
• Coordinate international case management, medical repatriations and the repatriation of mortal remains.
• Adjudicate cases as per product benefits, limits and conditions.
• Maintain detailed and accurate records of client interactions, appointments, and treatment outcomes.
• Facilitate the repatriation of mortal remains.
• Administrative tasks.
• Call taking and other ad hoc duties.
  
  

COMPETENCIES

• Showing Composure: Remains calm and does not get anxious before or during important events. Works well under pressure.
• Examining Information: Analyses and processes information very effectively when solving problems. Very curios and good at asking probing questions.
• Conveying Self Confidence: Self-confident and positive about themselves. Strong sense of own worth and feels in control of their future.
• Documenting Facts: Communicates well in writing, readily understand the logic behind an argument and will ensure that all the relevant facts are taken into consideration.
• Checking Things: Very thorough and even perfectionistic, ensures that things are done properly, delivering high quality work with great attention to detail.
• Producing Output: Works at a fast pace, works well when busy and copes well with multi-tasking.
• Managing Tasks: Very effective at planning and organizing, identifies clear priorities and milestones.
• Articulating Information: Is articulate in giving presentations; is eloquent and explains things well; projects social confidence when articulating information.
• Following Procedure: Extremely rule following, procedural and risk averse.
• Understanding People: Good at listening and understanding how others are feeling and why people behave as they do. Is attentive and understands what motivate others.
  
  

Job Category: Call Centre Medical Case Manager

Job Type: Full Time

Job Location: Johannesburg