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Case Manager
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Employment Type: Permanent
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Reference No: MHS231/2024
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Khayelitsha District Hospital, Chief Directorate: Metro Health Services
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| Responsible for the management and implementation of Case Management policies, protocol and procedures in the hospital. Perform operational Case Management functions inclusive of pre-authorisation and clinical review to ensure compliance with Case Management policies and procedures. Conduct clinical audits of patient accounts to ensure accuracy of invoices for submission to medical aids and state departments. Provide support to the hospital Fees Department in terms of follow-up of outstanding medical scheme and state department balances and account queries. Assist with EDI rejections to ensure timeous submission of medical scheme invoices. Provide quotations to H2, H3 and Foreign patients. Supervision of staff & liaison with relevant role players in matters relating to Case management. Assist Hospital Management in the distribution of Quality Client Care. Compile statistical reports. |
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| Appropriate experience in Case Management/Medical Aid Environment and Managed Health Care policies and protocols. Appropriate experience in ICD-10 diagnostic and procedural code assignment |
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| Appropriate three-year health related National Diploma/Degree registrable with the Health Professions Council of South Africa (HPCSA) or South African Nursing Council (SANC). |
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| Knowledge of the Uniform Patient Fees Schedule, Hospital Information Systems and EDI (Electronic Data Interchange). Knowledge of the Medical Aid Act 131 of 1998 and the application of Prescribed Minimum Benefit (PMB) legislation i.e. the Chronic Disease List (CDL) and the Diagnostic Treatment Pairs (DTP). Knowledge of and experience in ICD-10 Codes assignment and the ability to link patient diagnosis with procedure codes. Knowledge of RAF and other state departments. Computer Literacy ability to work with MS Excel and Web-based Programmes (medical aids). |
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| Mr N Sitonga tel. no. (021) 360 4734, email: Ntsikelelo.Sitonga@westerncape.gov.za |
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| No payment of any kind is required when applying for this post. The pool of applicants will be considered for other vacant Case Manager post within the Chief Directorate: Metro Health Services, for a period of 3 months from date of advert. Candidates may be subjected to a written/practical/oral assessment and competency test. |
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Remuneration:
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R 376 413-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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11/1/2024 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: 11/22/2024 12:00:00 AM
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