Date | 2024-10-09 |
---|---|
Job Title | Pre-Authorisation Consultant |
Employer | More Information |
Salary | |
Category | Healthcare Nursing |
Location |
Gauteng / Johannesburg |
Job Summary
Key
Responsibilities:
Pre-Authorisation of Hospital Admissions and Procedures: Evaluate and approve pre-authorisation requests for hospital admissions, surgeries, and specialised medical treatments. Assess medical necessity and appropriateness based on clinical guidelines, scheme rules, and patient history. Review hospital documentation, including treatment plans, diagnostic reports, and clinical assessments to ensure appropriateness of care. Clinical Collaboration: Liaise with doctors, specialists, and hospital staff to obtain necessary medical information for authorisations. Communicate effectively with healthcare providers to clarify treatment protocols and authorisation decisions. Provide advice on alternative treatment options when necessary to align with the clinical and financial guidelines of the medical scheme. Documentation and Reporting: Maintain thorough records of all pre-authorisation decisions and ensure compliance with audit and reporting requirements. Prepare reports and analysis on hospital pre-authorisation trends, approval rates, and cost implications. Risk and Compliance Management: Identify potential risks in hospital care plans, providing recommendations to mitigate unnecessary expenses and maintain quality of care. Ensure compliance with all healthcare regulations and scheme rules related to hospital care and authorisation processes. Key Skills & Competencies: Advanced clinical knowledge, particularly in a hospital environment. Familiarity with hospital care workflows, surgical procedures, and inpatient management. Strong understanding of managed care principles and medical aid regulations. Excellent communication and collaboration skills for working with hospital staff and healthcare providers. Strong decision-making skills, with the ability to evaluate clinical risks and financial impacts. Proficiency in medical coding and understanding of hospital billing processes. Minimum
Requirements:
Education: Registered Nurse (with SANC) Professional Membership: Registered with the South African Nursing Council (SANC) Experience: At least 3-5 years of clinical experience, with significant exposure to a hospital environment, including ICU, surgical, or medical ward experience. Prior experience in managed care, case management, or pre-authorisation is an advantage. Skills: Proficiency in clinical assessments, understanding of hospital-based treatments, and working knowledge of healthcare systems/software.
Pre-Authorisation Consultant position available in Gauteng, Johannesburg. This job position was posted by . The job has been posted on 2024-10-09 in the Healthcare Nursing category
Click Go Apply to apply online!
You might also like to look at the available jobs in the same area.
Apply directly for this position
Some posts have contact information included with other instructions. All applicants are urged to read the instructions carefully.
We will list jobs at the bottom of each job, so feel free to scroll down and continue your search.
We do not accept any job applications and merely offer the service of daily jobs being mined and displayed on our job portal.
Each job post has a link to take you directly to the original post to apply on their website or the original website where the post came from.
Here are some more related positions
Johannesburg: Pre-Authorisation Consultant
Key Responsibilities: Pre-Authorisation of Hospital Admissions and Procedures: Evaluate and approve pre-authorisation requests for hospital admissions, surgeries, and specialised medical treatments. Assess medical necessity and appropriateness based on cli
View Job
Pre-Authorisation Consultant
Pretoria: Medical Pre-Authorisation Consultant (Enrolled Nurse) posted by Qetello
Together with our client in Pretoria, we are recruiting for a Medical Pre-Authorisation Consultant. The ideal candidate must have a completed qualification as an Enrolled Nurse and must be registered with SANC, with at least 2 years experience in Managed H
View Job
Medical Pre-Authorisation Consultant (Enrolled Nurse)
Pretoria: Medical Pre-Authorisation Consultant (Enrolled Nurse) posted by Qetello
Together with our client in Pretoria, we are recruiting for a Medical Pre-Authorisation Consultant. The ideal candidate must have a completed qualification as an Enrolled Nurse and must be registered with SANC, with at least 2 years experience in Managed H
View Job
Medical Pre-Authorisation Consultant (Enrolled Nurse)
Email Alerts
Click the button below and submit your email to receive email alerts with the latest jobs.
This service is offered by Result Generation
We do not save your information, and your email is the only information we forward to the service.
If you wish to unsubscribe, please click here