Monday , May 27 2024

Netcare Vacancies – Senior Case Manager

Website Netcare

Job Description:

The Senior Case Manager is responsible for the collaborative process of assessment, planning, facilitation, care condition, evaluation and advocacy for appropriate options and services, balancing the interests of the patient, the funder and the hospital

Job Responsibilities:

  • Application of clinical knowledge in the risk management of patients in terms of length of stay, level of care and medical aid benefits available
  • Active engagement, communication and Consultation with multidisciplinary team relating to managed health care of patient
  • Facilitate and co-ordinate authorisation process for transfer of patients to alternate care facilities or home
  • Accurate and appropriate clinical motivation for patients length of stay and level of care in hospital
  • Management of billing and case management of accounts on alternate reimbursement contracts
  • Query resolution relating to managed health care of in progress patients
  • Ensure appropriate clinical information is transmitted to funders
  • Clinical coding as per work allocation
  • Facilitate onsite case management processes with the fund onsite case manager
  • Final authorisation of patient accounts prior to final billing as per work allocation

Job Requirements:

  • Billings experience will be an advantage

Qualification & Experience:

  • Minimum 3 years nursing experience in a multidisciplinary hospital environment
  • Intensive Care or theatre nursing experience an advantage
  • Hospital or Medical Scheme Case Management experience

Job Details:

Company: Netcare

Vacancy Type: Full Time

Job Location: Pretoria, Gauteng, SA

Application Deadline: N/A

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