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Vacancy Details

		A job opportunity

A job opportunity exists for the right candidate in Western Cape

The Department of Health and Wellness is guided by the principles of Employment Equity. Candidates with disabilities are encouraged to apply and an indication in the regard will be appreciated. Note: No payment of any kind is required when applying for any of the positions advertised by the Western Cape Government.

Experience:
Case Manager
Employment Type: Permanent
Reference No: CWD28/2021
Montagu Hospital and Robertson Hospital, Cape Winelands Health District

Appropriate experience in liaison with medical aid (funders) and managed care organisations with regards to MHC policies, protocols, optimal fund utilisation and updated clinical information. Appropriate experience in Case Management/Medical Aid Environment. Appropriate experience in ICD 10 codes assigned and the ability to link patient diagnosis with procedure codes.

Minimum educational qualification:
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).

Competencies (knowledge/skills):
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). Excellent written and verbal communication in at least two of the three official languages of the Western Cape.

Enquiries:
Mr E De Bruyn, tel. no. (023) 626-8524

Duties (key result areas/outputs):
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 and the provision of quotes. Provide support to the hospital Fees Department in terms of follow-up of outstanding medical scheme and state department balances, account queries and provide quotations to H2, H3 and Foreign patients. Assist with EDI rejections to ensure timeous submission of medical scheme invoices. Assist Hospital Management in the distribution of Quality Client Care and compilation of statistical reports.

Inherent requirement of the job:
Valid (Code B/EB) drivers licence.




Remuneration:
R 316 791 - R 373 167 per annum Annual salary plus service benefits (13th cheque, employer's contribution to the pension fund, housing and medical aid allowance).

Starting Date:
5/21/2021 12:00:00 AM

NOTICE TO ALL
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.
Closing date: 6/11/2021 12:00:00 AM

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