We have the following vacancies available with the Melomed Group:
CASE MANAGERS
Requirements:
- Qualified Registered Nurse
- A qualified EN with relevant experience would be considered
- Both need to be registered with SANC and provide 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 experience 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
- Attention to detail
- Ability to cope well under pressure
Key Outputs:
- 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 where medical aids request them from their hospitals as part of their assessing process
- Monitor patient admissions and identify those who have limitations, restrictions, placed 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
- Handle patient queries
- Update hospital information
Interested applicants are requested to submit their applications to
Please quote reference #Case Manager in the subject line.
Melomed is an equal opportunity employer. Only short-listed persons will be contacted.
Job Type: Full-time
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