The Case Manager utilizing clinical knowledge and expertise, mitigates financial risk through comprehensive of care. • Monitor and action risk related to medical aid benefits and hospitalization • Ensure accurate Timeous, effective communication and follow up with medical aids • Review authorization aspects approved, mitigating regarding patient treatment • Adhere to the NHN Managed Health Care rules of engagement • Compliance with Degree/Diploma Nursing qualification and/or Case Management qualification • Diverse clinical nursing experience
National Hospital Group is seeking Qualified Case Managers to join their growing operation on a National successful candidates will be responsible for managing the financial and clinical risks of the patient verification and workflow processes Ensuring effective management of quality outputs by Performing quality walkabouts Ensuring the compliance to Hospitals policies and managing authorisations and claim submissions, rejections rejections and delays Ensuring governance and risk management by monitoring and adhering to patient services
charged Build and maintain collaborative working relationships as part of the hospital emergency centre's multi-disciplinary Techniques Registered with SANC or with HPCSA as a Medical Technician in the category of Phlebotomy Sound of the National Health Act and medical ethical guidelines in the medical pathology field Familiar with with anatomy, physiology and medical terminology relevant to medical pathology Strong interpersonal skills