Netcare Vacancies 2023 – Case Manager

Job Description:

The Case Manager utilising clinical knowledge and expertise, mitigates financial risk through comprehensive accurate coding of hospital events; as well as the justification of hospitalisation encompassing level of care and length of stay

Job Responsibilities:

• Compliance with all industry relevant legislative acts, regulations and circulars
• Work effectively and co-operatively with others to establish and maintain good working relationships that are mutually beneficial.
• Liaise with a network of internal and external stakeholders.
• Accompany managed Care Organisation Case Managers on ward rounds in the hospital, if required.
• Effective communication to medical schemes by utilising the rules of engagement published in the Netcare Tariff and Billing Guidelines.
• Monitor and action risk related to medical aid benefits and hospitalisation.
• Application of clinical knowledge in the risk management of patients in terms of length of stay, level of care and medical aid benefits available.
• Provide clinical data to substantiate length of stay and level of care.
• Ensure correct clinical coding for all patients.
• Ensure appropriate, complete and relevant diagnostic and procedural coding of all patient records within the hospital.

Job Requirements:

• Develop case management skills and expertise.
• Nursing and pharmacy policies and procedures.
• 3 years professional healthcare experience.
• Ability to develop and maintain clinical knowledge.

Qualification & Experience:

• Qualification in associated Healthcare sciences or Managed care/ Case management.
• B Degree/Diploma Nursing qualification or equivalent NQF level 6.
• Registered nursing qualification with registration at South African Nursing Council

Job Details:

Company: Netcare

Vacancy Type:  Full Time

Job Location: Boksburg, Gauteng, SA

Application Deadline: N/A

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