Case Manager (spinal Programme Management

Pretoria, Gauteng, South Africa

Job Description

Monthly Cost To Company (Market related, Negotiable)
Join Our Specialist Team -- Case Manager in Spinal Programme Management
Are you passionate about transforming lives through compassionate care and clinical excellence?
Our client in the medical industry is seeking a proactive, empathetic, and highly organised Case Manager to join their dynamic team dedicated to spinal injury rehabilitation and long-term support.
PLEASE NOTE THAT NO CV'S WILL BE KEPT FOR FUTURE USE. ONLY APPLY IF YOU QUALIFY IN FULL.
INTRODUCTION
Our client is an accredited managed health organisation that service clients in the medical scheme industry. They are privileged to have one of the growing medical schemes in South Africa as a client and a new opportunity and position has presented itself in their commitment to ensure that our medical scheme beneficiaries are supported to access healthcare services.
PURPOSE OF THE POSITION:
To actively manage the access, clinical appropriateness and risk (both financial and clinical) of all requests for services pertaining to back and neck pain management, spinal surgery, scans and associated healthcare services in accordance with the relevant scheme rules, clinical protocols and funding guidelines.
To critically consider and propose relevant treatment alternatives that include, but are not limited to, conservative treatment options like physiotherapy.
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:

  • Registered Nurse with valid registration with SANC
OR
  • Clinical Associate (Bachelor of Clinical Medical Practice (BCMP)) with valid registration with HPCSA
SKILLS AND COMPTENCIES REQUIRED:
  • Thorough, well-grounded clinical knowledge of hospital admissions, LOS and LOC.
  • Excellent knowledge of the South African Healthcare industry and prevailing legislation, current coding structures i.e. ICD10's, CPT4, NRPL, PMB conditions and clinical protocols
  • Extensive clinical knowledge related to all aspects of holistic patient management.
  • Work experience within Orthopaedic and/ or Surgical theatre and wards will be advantageous.
  • Solid understanding of value-based care.
  • Demonstrated ability to manage a portfolio of active patient cases and to accurately update and maintain patient case information.
  • Outcome focused with the ability to manage competing demands
  • Establishing and maintaining effective relationships with key stakeholders.
  • Excellent telephonic and written communication skills (will be tested)
  • Computer literate - MS Office Suite (intermediate) required.
  • MIP Application System experience will be advantageous.
  • Reporting - MS Excel (intermediate) required (will be tested)
For more information please contact:
Dawn Hamer

Beware of fraud agents! do not pay money to get a job

MNCJobs.co.za will not be responsible for any payment made to a third-party. All Terms of Use are applicable.


Job Detail

  • Job Id
    JD1470271
  • Industry
    Not mentioned
  • Total Positions
    1
  • Job Type:
    Full Time
  • Salary:
    Not mentioned
  • Employment Status
    Permanent
  • Job Location
    Pretoria, Gauteng, South Africa
  • Education
    Not mentioned