Case Manager

Busamed · KwaZulu-Natal

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Summary

  • The Case Manager will be responsible for the liaison between the patient and medical aids in order to secure payment for the hospital.

Responsibilities and Duties

  • Ensure all the relevant details on Hospital Billing System are updated and are accurate
  • Supply all details regarding patients' history to Clinical partners
  • Monitor and control costs for Managed Care Organisation patients
  • Confirm length of stay for all Managed Care Organisations patients
  • Accompany Managed Care Organisation Case Managers on ward rounds in the hospital
  • Assist with final authorisation of Managed Care patient files
  • Ensure correct coding for all Managed Care Organisation patients
  • Consult with the relevant service providers regarding the patient care treatment
  • Assist with the transfer of patients to Rehab Hospital or step down facilities
  • Arrange in-service training for relevant staff to meet the needs of the theatre department
  • Liaise network of internal and external stakeholders to ensure that managed care of patients is maintained
  • Actively participate as a member of a team to achieve goals
  • Active involvement in own professional development to maintain a satisfactory level of skill and knowledge
  • Work effectively and co-operatively with others to establish and maintain good working relationships that are mutually beneficial
  • Develop collaborative relationships to help accomplish work goals

Requirements

  • Grade 12 or equivalent NQF level 4 qualification
  • Diploma in Nursing Qualification is essential

Work Experience

  • Previous Case Management experience advantages

Knowledge

  • Intermediate computer skill Excel and Word
  • Excellent Interpersonal and communication skills
  • Knowledge of Medical Aids

Deadline:8th September,2026

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