Pre-Authorisation Case Manager
Posted on 2025-04-09
| Employer | SD Recruitment (Pty) Ltd |
|---|---|
| Salary | 450000 |
| Category | Medical |
| Location | Gauteng / Gauteng |
Job Summary
Key Performance Areas:
- Pre-Authorisation of member hospital admissions based on scheme benefits and departmental protocols.
- Manage high care and general ward cases
- Telephonic Case Management of surgical and medical cases
Job Key
Responsibilities:
- Pre-authorise hospital admissions and capture details on the IMED system.
- Communicate with medical advisors for accurate case management.
- Provide hospital updates and manage cases via phone and email.
- Refer cases for specialised management as required.
- Monitor ongoing hospital cases and negotiate discounts.
- Address member queries related to hospitalisation and benefits.
- Manage written communication, including motivation reports.
- Ensure cost containment of hospital admissions.
- Maintain call centre SLA compliance.
- Collaborate with hospitals, doctors, and members.
- Provide clinical expertise to the organisation and assist healthcare personnel.
- Manage high-care and general ward cases, including rehabilitation and step-down admissions.
- Negotiate discounts for prosthetics and report cost savings.
Pre-Authorisation Case Manager position available in Gauteng, Gauteng. This job position was posted by SD Recruitment (Pty) Ltd. The job has been posted as a char8000 ad on 2025-04-09 at 17:02:27 in the Medical category
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