Job Description
About the Role
We are seeking an experienced Case Manager to join our preauth department at Affinity Life Limited in Benoni. The successful candidate will play a crucial role in improving clinical outcomes, increasing patient satisfaction, and promoting cost effectiveness.
Key Responsibilities
- Manage Pre Auth cases: Assist to determine admission requirements.
- Assist to provide the pre-auth team with valid recommendations for pre-auth request.
- Coordinate and provide care that is safe, timely, effective, efficient, equitable, and client centred.
- Review case progress and determine case closure.
- Assess treatment needs.
- Monitor and evaluate treatment plans and progress.
- Facilitate hospital admissions and LMS dispatch.
- Help members make informed decisions about treatment options.
- Promote quality and cost-effective interventions and outcomes.
- Adhere to professional standards as outlined by protocol, rules, and regulations.
- Maintain constant contact with treatment DR/Hospital.
- Educate members and medical staff of limits of benefits.
- Respond to queries and complaints within SLA (24 Hours).
- Maintain high standard of product knowledge.
- Monitor and recommend training interventions within pre auth department.
Requirements
- Clinical Experience
- Healthcare industry experience
- Computer Aided Dispatch System
- Managed Healthcare experience
Qualifications
- Matric
- Diploma or Degree in Nursing as a Registered Nurse
How to Apply
Click the green “Go Apply” button below to apply directly online with the employer.
About Healthcare / nursing Jobs in Gauteng
In Gauteng, the healthcare sector is a significant contributor to the local economy, employing thousands of professionals in various roles. The demand for skilled healthcare workers remains high due to an aging population and increasing healthcare needs. This has led to a growing number of job opportunities in this field.
Typically, salaries for nursing positions in Gauteng fall within broad ranges, with entry-level positions often ranging from R600 000 to R1 200 000 per annum, depending on the specific role and employer. More experienced professionals can expect higher salaries, up to R2 500 000 or more, but these figures may vary widely depending on factors such as experience, company size, and industry sector. For example, those working in high-demand areas like emergency care or critical care may earn higher salaries.
Common skills required for nursing positions in Gauteng include a strong foundation in life sciences, excellent communication and interpersonal skills, the ability to work well under pressure, and proficiency in medical software systems. Other essential skills often include critical thinking, problem-solving, and leadership abilities. While specific requirements may vary depending on the employer, these general skills provide a solid foundation for success in this field.
Many industries in Gauteng employ nursing professionals, including the healthcare sector itself, as well as various other sectors such as technology industry, manufacturing sector, and financial services sector. These roles often involve working in hospitals, clinics, or community health settings, but may also require working in non-traditional environments like corporate offices or research institutions.
For those considering a career in nursing, there are numerous opportunities for professional development and advancement. Typically, registered nurses can expect to progress into specialist positions, such as nurse practitioner or clinical nurse manager, within 5-10 years of experience. Additionally, many employers offer training programs and continuing education opportunities to help staff develop new skills and stay up-to-date with industry developments. With dedication and hard work, nursing professionals in Gauteng can enjoy a rewarding and challenging career in this dynamic field.
This information provides general career guidance. Actual salaries and requirements vary by employer.
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