Case Manager
at Melomed Private Hospitals
Western Cape, Western Cape, South Africa -
Start Date | Expiry Date | Salary | Posted On | Experience | Skills | Telecommute | Sponsor Visa |
---|---|---|---|---|---|---|---|
Immediate | 19 Jan, 2025 | Not Specified | 20 Oct, 2024 | 3 year(s) or above | Good communication skills | No | No |
Required Visa Status:
Citizen | GC |
US Citizen | Student Visa |
H1B | CPT |
OPT | H4 Spouse of H1B |
GC Green Card |
Employment Type:
Full Time | Part Time |
Permanent | Independent - 1099 |
Contract – W2 | C2H Independent |
C2H W2 | Contract – Corp 2 Corp |
Contract to Hire – Corp 2 Corp |
Description:
- Assess patient conditions and needs to develop appropriate care plans
- Interact with patients and medical aid schemes
- Resolve patient and medical aid scheme queries
- Update all information timeously and accurately
- CPT and ICD coding
- Obtain doctors letters, motivations, and justifications in all appropriate cases under managed care of where medical aids request them from their hospitals as part of their assessing process
- Monitor patient admissions and identify those who have limitations, restrictions, place by their managed care/ medical aid structures e.g. length of stay, cost restrictions, fixed fees, per diem and other limiting fees or drugs and/ or formularies
- Maintain a control system that ensures the systematic monitoring of managed care patients
- Handling patient queries
- Update hospital information
- Qualified Registered Nurse
- A qualified EN with relevant experience would be considered
- Both need to registered with SANC and proof of indemnity cover
- Minimum 3 years nursing experience in a multidisciplinary hospital.
- Experience and exposure in Theatre and/or ICU would be advantageous
- Hospital or Medical Aid scheme case management would be an advantage.
- Experience in ICD 10 and CPT coding is essential
- Knowledge of Prescribed Minimum Benefits (PMB) Scheme rules and policies
- 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 detail
- Ability to cope well under pressure
Responsibilities:
Please refer the Job description for details
REQUIREMENT SUMMARY
Min:3.0Max:8.0 year(s)
Hospital/Health Care
Pharma / Biotech / Healthcare / Medical / R&D
Health Care
Graduate
Proficient
1
Western Cape, South Africa