Hospital Case Manager

Job Description:

To coordinate the hospital case management process and facilitate the communication process between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation.

Job Responsibilities:

• Minimise financial risk by effectively managing patient stay
• Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems
• Ensure clinical coding standards are adhered to as per Level 3 coding guideline
• Ensure correct and timeous finalisation of cases to facilitate reimbursements from funders of claims
• Consistently and timeously communicate with Funders as contractually agreed through the relevant case management channels

Job Requirements:

• Computer literate (Microsoft Office)
• Scientific nursing principles and process
• Patient admin programmes on the AS400 system
• Anatomy (including terminology)
• Authorisation and motivation of Level of Care; Length of Stay; Short Payments etc.
• Funder Contracts; Medical aid requirements/narrations