Case Manager- Lesego Private Hospital View All Careers

Description

A vacancy exists for a Case Manager, reporting to the Hospital Manager. The position’s primary responsibilities include efficient patient case management and the delivery of an efficient and professional service to the internal and external customers. The successful candidate will be goal oriented with strong customer, quality, and performance focus. 

Critical Outputs

Ensure that pre-admission and pre-authorization information is accurate and in accordance with hospital and funder procedures. 

Carry out clinical coding in accordance with CPT/CCSA and ICD requirements.  

Daily ward rounds for effective clinical update communication and timeous follow up with medical aids.  

Maintain patients’ clinical status in accordance with funder approval requirements for the duration of hospitalization; keeping patients informed and managing the entire hospital stays’ financial risk. 

Provide complete and accurate updates and discharge information of all accounts. 

Maintaining accurate accounts of all admissions 

Handle patient files in accordance with hospital procedures.  

Timeous electronic submission of accounts and follow up on short payments arising from case management related issues.  

Ensure the adherence of hospital staff to funder rules and coding procedures. 

Keep well informed on legislation pertaining to funders and related Health Care matters. 

Requirements

Grade 12.

Nursing: SANC registration RN or EN, with Case Management qualification/experience.

Nonclinical case managers with Case Management qualification and experience.

3 – 5 years’ experience in clinical coding, private hospital case management and Medical Aid administration procedures. 

Knowledge of hospital billing, funder contracts and tariffs would be an advantage.  

Have sound computer literacy skills and working knowledge of MS office, word and excel.  

Competencies

• Collaboration/ Relationship Building
• Report writing
• Analytical thinking
• Problem-solving, analysis and judgement
• Resilience
• Engaging diversity
• Verbal & written communication and presentation skills
• Negotiation
• Influencing
• Planning
• Customer responsiveness
• Organisational awareness
• Excellence and quality orientation
• Ethical behaviour
• Technical and professional knowledge
• Adaptability
• Attention to detail
• Coaching
• Conflict resolution
• Decision making
• Organising

Departments

• Admin