Rounds: Accompany Managed Care Organization Case Managers during ward rounds within the hospital.
Minimum Education: Matric
Minimum Experience: Registered Nurse with Diabetes experience
Registration Required: Registration with the South African Nursing Council
Duties a
The Case Manager provides hospital utilisation management, education/training, and other clinically based professionals such as the Medical Advisor, other Case Management nurses within the organisation, dieticians advantage • Minimum of 3 – 5 years' experience in case management within a medical scheme or managed care environment reviews, case management within a hospital environment and/or primary care case management will be an
The Case Manager utilising clinical knowledge and expertise, mitigates financial risk through comprehensive Nursing qualification Case Management qualification AN ADDED ADVANTAGE Case Management experience ICD-10
make clear notes on the fraud monitoring and case management systems. Analyse alerts flagged on the fraud incidents immediately. Action all cases in the Case Management System Where fraud is confirmed, ensure necessary taken to prevent further exposure, update the Case Management System with the correct fraud type and details
make clear notes on the fraud monitoring and case management systems. Analyse alerts flagged on the fraud incidents immediately. Action all cases in the Case Management System Where fraud is confirmed, ensure necessary taken to prevent further exposure, update the Case Management System with the correct fraud type and details
3 to 5 years (previous pre-authorisation, case management experience in a managed healthcare environment assessing/auditing, pre-authorisation and specialised case management Providing detailed training feedback post probation
3 to 5 years (previous pre-authorisation, case management experience in a managed healthcare environment assessing/auditing, pre-authorisation and specialised case management Providing detailed training feedback post probation
patients Accompany Managed Care Organisation Case Managers on ward rounds in the hospital Assist with final
skills Basic MS Excel skills Understanding of case management tool Matric/Grade 12 with English and Maths