The Case Manager utilizing clinical knowledge and expertise, mitigates financial risk through comprehensive coding of hospital events, communication with funders on justification for hospitalization level of care of clinical knowledge in justifying patient hospitalization in terms of treatment, length of stay and level action risk related to medical aid benefits and hospitalization • Ensure accurate, specific and comprehensive regarding patient treatment • Adhere to the NHN Managed Health Care rules of engagement • Compliance with
Nursing or Case Management qualification / experience Case Management experience – Hospital / Funder Clinical Clinical Nursing / managed healthcare experience ICD-10 / CPT coding qualification or experience SAP IS-H Office The main purpose of this position: The Case Manager utilising clinical knowledge, experience and patient risk through comprehensive and accurate coding of hospital events Communication with funders on justification hospitalisation level of care and length of stay in hospital Duties & Responsibilities: Conducting ward
Human Resources / BTech Human Resources and/or Hospitality related (industry specific) qualifications
Matric + BCom Marketing / BTech Marketing and/or Hospitality related (industry specific) qualifications
Matric + BCom Marketing / BTech Marketing and/or Hospitality related (industry specific) qualifications
Matric + BCom Marketing / BTech Marketing and/or Hospitality related (industry specific) qualifications
medical aids in order to secure payment for the hospital Duties & Responsibilities: Liaise with network ensure that managed care of patients is maintained Monitor and control costs for Managed Care Organisation for all Managed Care Organisations patients Accompany Managed Care Organisation Case Managers on ward ward rounds in the hospital Assist with final authorization of Managed Care patient files Ensure correct correct coding for all Managed Care Organisation patients Supply all details regarding patient history to Clinical
comprehensive managed care for patients.
Human Resources Manager is responsible for the provision of support to line managers in the execution strategic focus areas. RESPONSIBILITIES INCLUDE: Proactively advise and educate managers and employees continuous adult learning in the Business Unit and/or Area • Influence the implementation of all transformation three-year Degree or Diploma in Human Resources Management or an equivalent NQF level 7 qualification • • Minimum 5 years' experience on a management level in a hospital HR environment • Extensive experience
external case managers; etc.) Daily workflow; managing deviances; coding; and case management processes Application