* Responsible for application of Clinical Knowledge in justifying patient Hospitalization in terms of treatment, length of stay and level of care.
* Monitor and action risk related to medical aid benefits an Hospitalization.
* Ensure accurate clinical Coding
* Timeous, effective communication and follow-up with Medical Aids.
* Review Authorization aspects
* Liaise with Network of internal and external stakeholders regarding patient treatment
* Adhere to NHN Managed Healthcare Rules
* Compliance with legislative acts, regulations and circulars.
Requirements:
**Registered Nurse or Case Management Qualification
**Clinical nursing experience
**3 Years Case Management experience with Specialized Units - ICU
**ICD 10 / CPT Coding qualification or Experience
**SAP IS-H experience - Advantageous
**Proficiency of Microsoft Office Products
