Purpose of the position The core purpose of the Integrated Care Case Manager role is to assess the financial risk and impact of a hospitalized member on the scheme, minimizing this risk by recommending cost-effective medical treatment at the most appropriate facility. The Integrated Care Case Manager facilitates seamless coordination between Medihelp, the member, and service providers to ensure optimal allocation of treatment benefits, reducing complications and preventing re-admissions while effectively managing overall risk. Requirements Grade 12, with a completed degree/diploma as a registered nurse and currently registered with the SANC. Four years of relevant experience in Managed Healthcare or experience as a registered nurse in a hospital environment, Key Competencies Good verbal and written communication skills Computer literate Customer focus Good negotiation and decision-making skills Comprehensive knowledge of the Medical Scheme Act Willing to be multi-skilled in other sections within managed care

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