Case Manager - Kimberley
Glasshouse Recruiting
Kimberley, Northern Cape March 18, 2024 - April 18, 2024 Registered Nurse Job Overview Requirements: B Degree Nursing Qualification or equivalent NQF level 6 1-2 years’ experience in an administrative role or auditing Advanced computer literacy The main purpose of this position: The Case Manager utilising clinical knowledge and expertise, mitigates financial risk through comprehensive and accurate coding of hospital events, communication with funders on justification for hospitalisation level of care and length of stay Duties & Responsibilities: Responsible for application of clinical knowledge in justifying patient hospitalisation in terms of treatment, length of stay and level of care Monitor and action risk related to medical aid benefits and hospitalisation Ensure accurate, specific and comprehensive clinical coding Timeous, effective communication and follow-up with medical aids Review authorisation aspects approved, mitigating financial risk and final releasing the case for billing Liaise with a network of internal and external stakeholders regarding patient treatment Adhere to the NHN Managed Health Care rules of engagement Compliance with all industry relevant legislative acts, regulations and circulars
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