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Case Manager
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Employment Type: Permanent
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Reference No: TBH107/2024
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Tygerberg Hospital, Parow Valley
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| Appropriate three-year health related National Diploma/Degree or equivalent registrable with the Health Professions Council of South Africa (HPCSA) or South African Nursing Council (SANC). |
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| Ability to link patient diagnosis (ICD10 Coding) with procedure codes. Knowledge of the UPFS and ability to perform clinical audits of patient accounts. Knowledge of the Medical Scheme Act 131 of 1998 and relevant PMB Regulations. Excellent verbal and written communication skills. Excellent interpersonal skills and the ability to act independently, objectively and with confidence and collaboratively as part of the healthcare team. Computer literate (Microsoft Office/Teams). Ability to work under pressure, handle a high work volume and meet strict deadlines. Strong critical thinking and problem-solving abilities. |
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| Appropriate experience preferably at hospital level, alternatively at a medical scheme or in a clinical environment. |
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| Ensure that pre-admission and pre-authorisation information is accurate and in accordance with hospital and funder procedures. Manage and implement Case Management policies, protocols and procedures timeously. Provide training and workshops when required. Liaise with internal and external stakeholders such as Funders and Managed care organisations with regards to treatment of patient, MHC policies, protocols, optimal fund utilisation, clinical information, diagnostic and procedural coding. Provide complete and accurate clinical updates and discharge information to Funders. Conduct clinical audits of patients’ accounts and ensure clinical auditing of the account controllers are accurate. Ensure accurate, specific and comprehensive clinical coding. Complete queries/requests of the Medical Scheme follow-up section timeously. Queries will include drafting of motivational letters where possible, obtaining authorisation, concurrent review of patient clinical information, i.e. length of stay, level of care, clinical coding and PMB. When handling or investigating a debtor query, ensure the account is accurately billed. Manage the workflow and supervise personnel of the Case Management department. Participate in interdisciplinary team meetings to optimize patient care. Provide estimations for all patient classifications. Provide Case management statistics on a weekly / monthly basis. |
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| Ms J Jooste, tel. no. (021) 938-4140 |
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| This post does not form part of any Occupation Specific Dispensation. Shortlisted candidates may be subjected to a practical test. |
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Remuneration:
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R 376 413 per annum - R 443 403 per annum Annual salary plus service benefits (13th cheque, employer's contribution to the pension fund, housing and medical aid allowance).
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Starting Date:
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10/25/2024 12:00:00 AM
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NOTICE TO ALL
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Candidates may be subjected to a competency test. No payment of any kind is required when applying for this post. As directed by the Department of Public Service and Administration, applicants must note that further checks will be conducted once they are shortlisted and that their appointment is subject to positive outcomes on these checks, which include security clearance, qualification verification, criminal records and previous employment.
- It will be expected of shortlisted candidates to be:
- available at the venue on the time and date as determined by the Department and
- bring along recently (not older than 6 months) certified copies of your Identity Document (ID), driver’s license (if applicable for the post), qualification and/or proof of registration at relevant statutory body. Failure to adhere to the aforementioned may lead to his/her application being disqualified and not further considered.
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Closing date: 11/15/2024 12:00:00 AM
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