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Johannesburg: Case Manager posted by Clinix Health Group Ltd

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Job Description

Job Summary: To plan, coordinate and execute case management work at hospital level. The incumbent utilises clinical knowledge to minimise financial risk and ensure accurate billing through comprehensive accurate coding of patient care. Minimum Qualifications and Experience: Diploma in Nursing 5 years experience as a hospital Case Manager Technical Knowledge of ICD-10 and CPT Coding Advance Certification in Intermediate coding – Preferred Knowledge of private health care operations Attention to detail and ability to confirm accuracy of files Minimum Job Requirements: Ensure compliance to case management procedures, standards and protocols. Plan, coordinate and execute Clinical coding in accordance with relevant CHG standards and protocols. Timeously and consistently communicate and follow up with Funders (Medical Aids, COID, Government, RAF, DOL, etc.) Provide appropriate clinical information to Funders in order to update Length of Stay, Level of Care, formulary utilisation, assistive devices / Prosthesis, diagnostic interventions, therapy intervention and procedural interventions and any required changes in patient treatment. Investigate and understand Funder, Doctors, Nurses and Patient needs to enable delivery of a quality service. Ensure timeous resolution of stakeholder queries and complaints and take ownership of case management and reimbursement related issues. Escalate potential risks that may lead to increased costs or financial losses. Maintain accurate records of patient care and timeously submit to funders to ensure the organisation is appropriately reimbursed for all services rendered. Liaise with the Billing department with regards to conversion of medical aid patients to cash patients. Adhere to statutory standards, policies and procedures within the business unit to ensure compliance at all times and take remedial action where necessary.

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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.

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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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