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Gauteng: Case Manager posted by Clinix Health Group Ltd

Job Description

About the Role

Clinix Health Group Ltd is seeking a skilled Case Manager to join our team, responsible for delivering effective case management processes and minimizing financial risk for the company. As a key member of our healthcare team, you will facilitate communication between all role-players by providing accurate and timely clinical information.

Key Responsibilities

  • Ensure authorizations on admissions (daily) is accurate as per SAP system.
  • Conduct daily case management rounds in allocated units to obtain updated clinical information from patient files.
  • Comply with case management procedures, Medical Scheme contracts, and legal aspects by utilizing available resources and systems (specifically the Case Manager Workstation on SAP).
  • Communicate consistently and timeously with Medical Schemes as contractually agreed through the relevant case management channels.
  • Obtain Doctors letters of motivation in support of all cases where Medical Schemes request these from the hospital as part of their assessing process.
  • Minimize financial risk by effectively managing patient stay.
  • Communicate daily statistics with Billings regarding number of files with case management and with Billings, to progress these files through the system as quickly as possible and to achieve the discharge to final bill target.
  • Resolve queries related to short payments by Medical Scheme, in conjunction with the Collections Department.

Requirements

  • Grade 12
  • Registered Nurse, currently registered with SANC
  • Certificate in Coding (advantageous)
  • 3 to 5 years experience in a private hospital or medical scheme environment in a Case management capacity
  • Working knowledge of ICD-10 and CPT codes
  • Computer proficiency SAP System or similar

Qualifications

  • Formal education/certifications: None mentioned.

Salary & Benefits

  • Salary range: Not specified.
  • Comprehensive benefits package: Not specified.

How to Apply

Click the green “Go Apply” button below to apply directly online with the employer.

About Healthcare / nursing Jobs in South Africa

The healthcare industry is a vital sector in South Africa, with a growing demand for skilled professionals to cater to the country’s increasing population and aging demographic. Generally, job seekers in this field can expect a dynamic and rewarding career with opportunities for growth and development. However, the South African job market can be competitive, and it’s essential to have a clear understanding of what to expect.

Typically, salaries for healthcare professionals in South Africa vary widely depending on factors such as experience, company size, and industry sector. Broadly speaking, entry-level positions tend to start within the range of R300 000 to R500 000 per annum, while senior roles can command salaries ranging from R800 000 to over R1 million per annum. However, these figures are only a general guide, and actual salaries may differ based on individual circumstances.

Common skills required for healthcare professionals in South Africa include strong communication and interpersonal skills, the ability to work under pressure, and excellent problem-solving and critical thinking abilities. Additionally, proficiency in Microsoft Office, electronic medical records, and patient data management systems is often expected. Many employers also place a strong emphasis on ongoing professional development, with training and certification programs available for both new entrants and experienced professionals.

The healthcare industry sector encompasses a wide range of roles, including nursing, clinical care, health administration, and research. Financial services sector hospitals, technology-enabled healthcare facilities, and non-profit organisations are just a few examples of the types of employers that commonly hire healthcare professionals. Manufacturing sector companies, government departments, and academic institutions also employ healthcare staff.

Career development opportunities for healthcare professionals in South Africa are numerous. Many organisations offer training programs, mentorship schemes, and career progression pathways to help employees develop their skills and expertise. With experience and additional education, healthcare professionals can move into leadership roles, become specialists, or pursue careers in education and research.


This information provides general career guidance. Actual salaries and requirements vary by employer.



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