Case Manager

Join our team and help make a real difference in healthcare. KEY RESPONSIBILITIES - Manage hospital utilisation and coordinate care between the medical scheme/managed care organisation, members, providers and the community. - Verify eligibility of cover in accordance with medical scheme rules and membership files. - Facilitate admission of the member to a suitable facility. - Assess co-morbidities and monitor clinical status. - Communicate with hospitals, treating doctors and healthcare professionals. - Update the level of care, length of stay and value to the hospital (in line with clinical guidelines and protocols). - Develop and facilitate discharge plans. - Refer members to Disease Management where appropriate. - Maintain accurate clinical and demographic records. - Visit high cost members in hospital as required. - Prepare and present cases at clinical meetings. - Prepare reports and case summaries. - Complete special projects and other assigned duties. - Perform other duties as needed. MINIMUM REQUIREMENTS - Clinical degree or diploma recognised by either the HPCSA or SANC or South African Nursing Council OR SANC. - Minimum 2 years’ experience in case management within a medical scheme, hospital or managed care. - Experience with chronic illness and targeted disease states. - Strong verbal and written communication skills. - Customer service focus. - Ability to solve problems in a customer friendly manner. - Understanding of the South African healthcare industry and prescribing information (or relevant). - Understanding of medical legislation. - Disbursing and case of medical scheme and healthcare financing terminology. - Current and continued registration with the accredited professional body with which the candidate aligns. ADVANTAGEOUS - Additional clinical qualifications. - Operating Theatre or ICU experience. - Quality management and medical records review experience. - Hospital or primary care case management experience. APPLY NOW Apply directly on CazVid.