Hospital Case Manager

3 days ago

Newcastle, New South Wales, Australia Mediclinic International Full time

Choose how often (in days) you want to receive a notification:Mediclinic Newcastle| Newcastle | South AfricaClosing date: 04/09/2025Number of positions: 1Recruiter name: Suvikha SivnathReference number: 62898Workplace Type:On-sitePermanentPlease note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profileMAIN PURPOSE OF JOBTo coordinate the hospital case management process and facilitate the communication process between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation.KEY RESPONSIBILITY AREASMinimise financial risk by effectively managing patient stayEnsure compliance to case management procedures, contracts and legal aspects by utilising available resources and systemsEnsure correct and timeous finalisation of cases to facilitate reimbursements from funders of claimsConsistently and timeously communicate with Funders as contractually agreed through the relevant case management channelsEnsure clinical coding standards are adhered to as per Level 3 coding guidelineLead and manage the people in the Case Management team (if applicable)REQUIRED EDUCATIONDESIRED EDUCATION: Registered Nurse / Professional Nurse or qualified ParamedicREQUIRED EXPERIENCEESSENTIAL MINIMUM EXPERIENCE: Minimum of 3 years in a clinical roleDESIRED EXPERIENCE: Experience in Theatre and or ICU; Medical aid background; Experience in private healthcare environment or experience as an ILS/ALS ParamedicREQUIRED JOB SKILLS AND KNOWLEDGEAnatomy (including terminology)Funder Contracts; Medical aid requirements/narrationsPatient admin programmes on the AS400 systemScientific nursing principles and processAuthorisation and motivation of Level of Care; Length of Stay; Short Payments etc.Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.)Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.)Daily workflow; managing deviances; coding; and case management processesApplication of clinical codes and finalisation thereofAll applicants will be considered, with the understanding that preference will be given in accordance with the Employment Equity Plan of Mediclinic Southern Africa, as well as internal applicants/employees that meet the minimum requirements.Please note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profileBecome a part of our Talent Community and we will get in touch with you as soon as there is a relevant opening that fits your skills, interests and experience.
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