Senior Case Manager
Registered Nurse / Enrolled Nurse

Apply by 20 October 2017

Main Purpose of the Job:

  • Check confirmations for L.O.S and L.O.C  relative to each patient
  • Check confirmations for L.O.S and L.O.C  relative to each patient
  • Assess patient clinical reports for communication to Medical Aids
  • Process updates with Medical Aid for each patient
  • Check all ICD, CPT Coding and authorization numbers
  • Handle communication and queries with Medical Aid Case Managers
  • Assist Patients/Doctors with patients requiring step down facilities
  • Liaising with Doctors, Nursing Staff and Patients

Education, experience and competencies required:

  • Strong Administration skills  Strong Administration skills
  • Nursing experience in ICU & NNICU an advantage, registered with SANC, previous Case Manager experience essential
  • Extensive clinical knowledge related to all aspects of patient management and medical aid updates
  • A valid Grade 12 or Matric Equivalent Certificate
  • Knowledge of Medical Aid Policies & Procedures
  • Computer literacy essential
  • Above average interpersonal and Communication Skills
  • Absolute compliance with Confidentiality Policies and Procedures

Administrative management involves the following duties and responsibilities but is not limited to:

  •  Case Management
    – Constantly monitoring patient status
    – Constantly liaising with Medical Aids updating patient status
    – Effective communication with Patients, Doctors, Nursing Staff, Medical Aids etc.
    – Ensure adequate record keeping.
    – General administration duties
  • Supervision of Case Managers
    – Ensure smooth running of the Case Management Department and daily operations
  • Maintaining standards
    – Ensure that the complete Case Management function is consistently performed on a daily basis.
  • Application of policies for the operation within the Hospital Industry
  • Ensuring adherence to all relevant statutes, statutory bodies, rules and regulations, disciplinary code, staff employee manuals

This is not a job description, but merely a guideline to facilitate application

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