Menu Close

Johannesburg: Case Manager – Soweto




Date 2024-07-04
Job Title Case Manager – Soweto
Employer
More Information
Salary Monthly
Category Healthcare Nursing
Location Gauteng
/ Johannesburg

Job Summary

Diploma in Nursing is ESSENTIAL Registered with the South African Nursing Council is ESSENTIAL You will 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 Liaise with Receptionist for authorisations Ensure compliance to case management procedures, standards and protocols Plan, coordinate and execute Clinical coding in accordance with relevant standards and protocols Ensure accurate, appropriate and complete diagnostic and procedural coding of all patient records in the hospital 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 required change in the facility Consult daily with all relevant health care providers with regards to patient treatment Ensure the maintenance of patients clinical status (subsequent interventions and treatments) in accordance to Funder requirements for the duration of hospitalisation Ensure the correct categorisation and management of different patient accounts to facilitate reimbursement by Funders Ensure accurate and timeous finalisation of cases to facilitate reimbursement by Funders Minimise financial risk by the effective management of patient hospitalisation Follow the established and approved escalation processes in the event of a decline of payment by Funders Ensure to remain in the group and facility targets of 3 days for WIP (work in progress) and DNYB (discharged not yet billed Build professional long-term relationships with Funders Investigate and understand Funder, Doctors, Nurses and Patient needs to enable delivery of a quality service Ensure service knowledge and advice is technically accurate and provide stakeholders with relevant information to keep them informed of products and service options Ensure timeous resolution of stakeholder queries and complaints and take ownership of case management and reimbursement related issues Ensure conflict resolution and respond to any complaints or concern Identify and participate in planned activities that are appropriate for own development Ensure knowledge transfer amongst peers by participating in coding information sharing sessions 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 Minimise financial risk by effectively managing patient stay Maximise revenue by applying clinical judgement to Length of Stay (LOS), Level of Care (LOC), formulary utilisation, assistive devices / Prosthesis, diagnostic interventions, therapy intervention and procedural interventions and required change in the facility Liaise with the Billing department with regards to conversion of medical aid to cash patients Ensure financial and case management documentation is maintained to support accurate record keeping and future requirements as per legislation and standards Ensure complete, timeous and accurate reporting with appropriate levels of escalation to enable effective decision-making Use systems optimally for data management Ensure feedback and progress reporting to stakeholders Adhere to statutory standards, policies and procedures within the business unit to ensure compliance at all times and take remedial action where necessary

Case Manager – Soweto position available in Gauteng, Johannesburg. This job position was posted by . The job has been posted on 2024-07-04 in the Healthcare Nursing category

Click Go Apply to apply online!


You might also like to look at the available jobs in the same area.

Apply directly for this position
Some posts have contact information included with other instructions. All applicants are urged to read the instructions carefully.
We will list jobs at the bottom of each job, so feel free to scroll down and continue your search.

We do not accept any job applications and merely offer the service of daily jobs being mined and displayed on our job portal.
Each job post has a link to take you directly to the original post to apply on their website or the original website where the post came from.


Here are some more related positions


Port Elizabeth: Medical / Managed Care Case Manager (Ee)

Role Purpose The purpose of this temporary role is to assist in the enhancement and management of cost-effective managed health care with the objective of promoting rational utilization of health care facilities and containing associated costs generated by


View Job
Medical / Managed Care Case Manager (Ee)

Johannesburg: Diabetes Case Manager

Minimum Education: Matric Minimum Experience: Registered Nurse with Diabetes experience Registration Required: Registration with the South African Nursing Council Duties and Requirements includes but is not limited to the following: Production of education


View Job
Diabetes Case Manager

Centurion: Insurance Financial Manager (Sage Intact Caseware),

Insurance Financial Manager (Sage Intact Caseware), Centurion, R1.2k tctc B Com Honors Completed Articles Knowledge of International Financial Reporting Standards . 3 years in the insurance industry and regulations Sage Intact. o Caseware. o Microsoft Of


View Job
Insurance Financial Manager (Sage Intact Caseware),

Centurion: Insurance Compliance And Contracts Manager (Law Degree Caseware Sage Intact),

Insurance Compliance and Contracts Manager (Law degree Caseware Sage Intact), Centurion, R500 – 1.2k ctc Bachelor of Law Degree 5 years’ post degree experience Certificate in area of Governance, Risk and Compliance. King Code on Governance Principles for


View Job
Insurance Compliance And Contracts Manager (Law Degree Caseware Sage Intact),

Pretoria: Case Manager

One of our clients in the Healthcare industry has a permanent vacancy available for a Case Manager to join their dynamic team. Purpose of the position: To actively manage the clinical appropriateness and risk (both financial and clinical) of all hospital e


View Job
Case Manager

Pretoria: Case Manager

PLEASE ONLY APPLY IF YOUR HAVE ALL THE NECESSARY EXPERIENCE. IF YOU DO NOT GET FEEDBACK WITHIN TWO WEEKS PLEASE CONSIDER YOUR APPLICATION AS UNSUCCESFULL. Enrolled/ Registered Nurse. Valid registration with SANC. 3 to 5 years experience within a managed he


View Job
Case Manager

Centurion: Insurance Compliance And Contracts Manager (Law Degree + Caseware + Sage Intact), posted by Recruitment Web South Africa

Insurance Compliance and Contracts Manager (Law degree + Caseware + Sage Intact), Centurion, R500 1.2k ctcBachelor of Law Degree5 years post degree experienceCertificate in area of Governance, Risk and Compliance.King Code on Governance Principles for Sou


View Job
Insurance Compliance And Contracts Manager (Law Degree + Caseware + Sage Intact),

Centurion: Insurance Financial Manager (Sage Intact+ Caseware), posted by Recruitment Web South Africa

Insurance Financial Manager (Sage Intact+ Caseware), Centurion, R1.2k tctcB Com + Honors + Completed ArticlesKnowledge of International Financial Reporting Standards.3 years in the insurance industry and regulationsSage Intact.o Caseware.o Microsoft Office


View Job
Insurance Financial Manager (Sage Intact+ Caseware),

Cape Town: Case Manager – Medical Advisor posted by Palesa Mbali Group

Position Purpose:To facilitate the setting of quality standards, policies, and procedures (clinical and non-clinical) for area. Ensure adherence to audit requirements, reporting and planning through evaluation, and coaching internal resources.Experience:5


View Job
Case Manager – Medical Advisor

Johannesburg: Case Manager posted by Palesa Mbali Group

To ensure clinical appropriateness of care at lowest possible cost without compromising quality of care. To use appropriate tools such as Burden of Care Criteria in the application of discharge planning. To manage the risk to the client by assessing the qu


View Job
Case Manager

Cape Town: Case Manager In Hospital posted by Palesa Mbali Group

Position:Case Manager In HospitalPosition Purpose:To coordinate care in allocated facilities, in order to improve health outcomes and manage the cost to the Scheme(/s). The case manager`s responsibilities start from patient admission to discharge and they


View Job
Case Manager In Hospital

Johannesburg: Case Manager posted by Palesa Mbali Group

Case ManagerPosition:Case ManagerDepartment:General and Specialized Case ManagementGrade:B4M1Position Purpose:To ensure clinical appropriateness of care at lowest possible cost without compromising quality of care. To use appropriate tools such as Burden o


View Job
Case Manager

Johannesburg: Case Manager In Hospital posted by Palesa Mbali Group

Position:Case Manager In HospitalPosition Purpose:To coordinate care in allocated facilities, in order to improve health outcomes and manage the cost to the Scheme(/s). The case manager`s responsibilities start from patient admission to discharge and they


View Job
Case Manager In Hospital

Port Elizabeth: Medical / Managed Care Case Manager (Ee) posted by Headhunters

Role PurposeThe purpose of this temporary role is to assist in the enhancement and management of cost-effective managed health care with the objective of promoting rational utilization of health care facilities and containing associated costs generated by


View Job
Medical / Managed Care Case Manager (Ee)

Gauteng: Diabetes Case Manager posted by Fusion Personnel

Minimum Education: Matric  Minimum Experience: Registered Nurse with Diabetes experience Registration Required: Registration with the South African Nursing Council Duties and Requirements includes but is not limited to the following:Production of


View Job
Diabetes Case Manager

Cape Town: Case Manager posted by SD Recruitment (Pty) Ltd

Skills  Excellent communication skills (written and spoken)  Excellent analytical and problem-solving skills  Excellent MS Office computer skills, i.e. Outlook, Word, Excel, Kronos, Clinic Manager, etc.  Attention to


View Job
Case Manager

Pretoria: Case Manager

Skills Computer skills and knowledge of MS Word, MS Excel, MS Office, Outlook and Internet Strong organizational skills, attention to detail and ability to prioritize Strong negotiation skills Language skills in English and strong interpersonal communicati


View Job
Case Manager

Johannesburg: Case Manager – Soweto

Diploma in Nursing is ESSENTIAL Registered with the South African Nursing Council is ESSENTIAL You will plan, coordinate and execute case management work at hospital level. The incumbent utilises clinical knowledge to minimise financial risk and ensure acc


View Job
Case Manager – Soweto

Cape Town: Case Manager: Physiotherapist posted by Palesa Mbali Group

Case Manager: Physiotherapist Chronic Medicine Management and aPMBGradeB4M1Position PurposeReporting to the PMB Supervisor, the role incorporates the evaluation of ambulatory PMB applications in line with reimbursement guidelines, communication with health


View Job
Case Manager

Pretoria: Case Manager

Our well-known client in the Automotive industry is looking for an experienced Case Manager Minimum requirements: Matric Motor vehicle technical qualifications (compulsory) Will investigate and resolve consumer complaints Handle incoming telephonic inquiri


View Job
Case Manager

Share this to someone who needs a job:
Posted in Uncategorized

More Jobs in Your Area