RN Case Manager: Care Coordination & Authorisation

Private Health Administrators (Pty) Ltd; Centurion; On-site; ZAR 420,000 - 600,000; Full time

Job summary

A health management company based in South Africa is seeking a Professional Registered Nurse to manage the spending of member funds through clinical interventions. The role requires at least 3 years of nursing experience, with a focus on patient care coordination and compliance with medical standards. Candidates should be adept in assessing treatment plans and educating members on healthcare options. This position may involve working with diverse healthcare providers to ensure optimal patient outcomes.

Qualifications

• At least 3 years of general medical and surgical nursing experience.
• ICU training or at least 1 year of ICU nursing experience.
• Minimum of 18 months of hospital pre-authorisation experience.

Responsibilities

• Review member medical records and treatment plans.
• Coordinate care with healthcare providers.
• Evaluate clinical information for medical necessity.

Skills

Patient care management

Clinical assessment

Problem-solving

Collaboration with healthcare providers

Education

Professional Registered Nurse certification

Job description

A health management company based in South Africa is seeking a Professional Registered Nurse to manage the spending of member funds through clinical interventions. The role requires at least 3 years of nursing experience, with a focus on patient care coordination and compliance with medical standards. Candidates should be adept in assessing treatment plans and educating members on healthcare options. This position may involve working with diverse healthcare providers to ensure optimal patient outcomes.