Job Description

MHR is urgently looking for an experienced Hospital Case Manager (Enrolled Nurse or Registered Nurse or Paramedic) to work part-time shifts at a private hospital in BLOEMFONTEIN in the Free State province.
Requirements

• Must be available immediately

• Registered with the South African Nursing Council as a Professional Nurse/Enrolled Nurse or with the HPCSA as a qualified Paramedic

• Case management experience is essential

• Desired experience: Experience in Theatre and or ICU; Medical aid background; Experience in private healthcare environment or experience as an ALS Paramedic

• Intermediate knowledge of Microsoft Office suite

• Knowledge of the Scientific Nursing Process and associated procedures

• Knowledge of the rules and regulations regarding medical aid schemes

• Knowledge of clinical codes and coding policies

• Knowledge of patient administration systems, policies and procedures

• Experience in a Managed Healthcare environment will be a strong recommendation

• Independent problem-solving and decision-making skills

• Good accuracy and attention to detail skills in order to maintain high standards of work output

Key Outputs

• Responsible for the case management processes

• Interacts with medical schemes to ensure that authorisations are provided timeously

• Verification of clinical coding as per policies and procedures

• Ensures accurate application and interpretation of specialised wards criteria

• Provides support for the management of alternative fee structures

• Liaison with doctors on funder requirements when necessary

• Continuous performance and quality management

• Interpretation and implementation of scheme benefit rules

• Maintains client service principles to ensure client expectations are met

Other Information

If you are interested in this opportunity and meet the requirements, apply directly by clicking on xe2x80x98Applyxe2x80x99. Kindly ensure that your profile is complete and up to date. For any online support, please contact our Career Centre:

• Free State, KwaZulu-Natal, Northern and Western Cape: T 0219436270 / talent@mhr.co.za

• Gauteng, Limpopo, Mpumalanga and North West: T 0219436269 / careers@mhr.co.za

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