Sessional Case Manager | General

LIFE Healthcare Group; Pretoria; On-site; ZAR 300,000 - 400,000; Part time

Job summary

A healthcare provider is seeking a Sessional Case Manager at Life Groenkloof Hospital to manage financial and clinical risks in a general ward. Responsibilities include ensuring accurate coding, submitting patient accounts, and maintaining quality outputs. Candidates should have a diploma or degree in Nursing or Physiotherapy, current SANC registration, and knowledge of hospital case management. Apply via email by August 19, 2025.

Qualifications

• Managing clinical risks and financial aspects of patients in a general ward.
• Ensuring compliance with policies and monitoring outcomes.
• Experience with hospital case management and coding is essential.

Responsibilities

• Maximising revenue through accurate coding and reporting.
• Managing quality outputs and operational excellence.
• Building and maintaining relationships with stakeholders.

Skills

Attention to detail

Problem-solving and analysis

Communication skills

Customer responsiveness

Professional proficiency

Education

Diploma or degree in Nursing, Physiotherapy, or related fields

Current SANC registration

Job description

A vacancy exists for a Sessional Case Manager (on a Fixed term contract) – General at Life Groenkloof Hospital, reporting to the Patient Services Manager. The successful candidate will manage the financial and clinical risks of patients in a general ward by ensuring accurate coding, clinical updates, and submission of patient accounts to achieve strategic objectives.

Critical Outputs

Ensuring the maximisation of revenue by:

• Ensuring accuracy of coding
• Applying and interpreting RSRT’s correctly
• Participating in meetings, reporting losses, and recommending corrective actions
• Monitoring insurance verification and workflow processes

Ensuring effective management of quality outputs by:

• Performing quality walkabouts and implementing corrective measures
• Implementing and monitoring quality improvement programmes
• Adhering to escalation processes to achieve QMS targets
• Monitoring Q-evaluator scores and corrective actions
• Investigating stakeholder complaints
• Maintaining customer service standards

Ensuring operational excellence by:

• Monitoring submission of accurate accounts to funders
• Updating length of stay and level of care information for funders
• Releasing care risk targets and submissions within two days of discharge
• Ensuring policy compliance and managing authorisations, claims, rejections, and delays
• Monitoring governance and risk management adherence
• Ensuring compliance with SLAs
• Closing billing checks timely

Managing relationships with stakeholders by:

• Building and maintaining internal relationships
• Providing feedback and training on RSRT contracts
• Communicating effectively with external stakeholders
• Managing escalated concerns and non-compliance issues

Requirements

• Diploma or degree in Nursing, Physiotherapy, or related fields covering Anatomy, Physiology, etc.
• Current SANC registration
• Knowledge of hospital case management and coding
• Understanding of funder contracts and hospital practices
• Computer proficiency

Competencies

• Attention to detail
• Problem-solving and analysis
• Resilience and diversity engagement
• Communication skills
• Professional proficiency
• Relationship building
• Customer responsiveness
• Organisational awareness
• Influencing skills
• Action and excellence orientation
• Ethical behaviour

Apply via email at [e-mail] by Tuesday, August 19, 2025. Internal and external candidates are encouraged to apply. Only shortlisted candidates will be contacted. For inquiries, discuss with your line manager or refer to the application process outlined in the advert.