Our client, a managed care organisation based in Pretoria is looking for a Case Manager. This is an equal opportunity organisation with various businesses and/ or subsidiaries that service clients in the medical scheme and insurance industries. Position: Case Manager (Member Management) Reporting to: Senior Specialist Clinical Management Location: On-site at the Head Office, Pretoria Contract Type: Fixed Term Contract for period of 12 months (with the possibility of becoming permanent thereafter) The purpose of the position To actively manage the clinical appropriateness and risk (both financial and clinical) of all hospital events and associated healthcare services in accordance with the relevant scheme rules, clinical protocols, and funding guidelines. To participate in the clinical review of exceptional cases and to engage with various stakeholders including treating providers, hospital case managers, medical advisors, and colleagues. Qualifications:
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