Vacancies at Life Healthcare – Case Manager

Job Description:

A vacancy exists for a Case Manager Specialised Units, based at Life The Crompton Hospital, reporting to Jensen Soobramoney, Finance and Administration Manager. The successful candidate will be responsible for the management of the financial and clinical administrative risks pertaining to patients in specialised units – Intensive care units, high care units and neonatal intensive care units.

Job Responsibilities:

• Communicating funder requirements / responses to attending clinicians and patients where necessary, and ensuring compliance with industry standards
• Conducting ward rounds and ensuring the accurate complete collection of clinic data from patient files and liaisons with nursing staff and attending clinicians
• Updating accurate clinical information to justify length of stay and level of care to medical funds of specialised unit cases and where operationally required general ward cases.
• Complying with governance and risk management requirements by ensuring adherence to patient services policies and procedures
• Ensuring the accurate submission of accounts to funders.
• Ensuring effective management of real time and manual messaging, including requests, responses, rejections and submissions.
• Ensuring compliance to service level agreements with internal and external stakeholders
• Updating and providing the necessary information to funders regarding high value items, limited benefits and protocols as defined by managed care organizations

Job Requirements:

• Understanding of business and change management principles
• Nursing qualification, Registered Nurse with at least five years’ experience on which at least 2 should be in a specialised unit
• Experience including proven leadership, change and people management
• Computer proficiency
• Working knowledge of COID
• Understanding of clinical coding, clinical terminology and anatomy, funder rules, co-payments and exclusions
• Current registration with the relevant professional / regulatory body

Job Details:

Company: Life Healthcare

Vacancy Type:  Full Time

Job Location: New Germany, KwaZulu Natal, South Afrca

Application Deadline: N/A

Apply Here

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