Hospital Case Manager, Durban

As a Case Manager, you will advocate for patients, optimize healthcare resources, and promote positive outcomes. Your expertise will streamline processes, enhance patient satisfaction, and contribute to the overall effectiveness of JMH healthcare delivery system.

KEY PERFORMANCE AREAS

Adhering to JMH policy regarding clinical updates within specified turnaround times and service level agreements.

Ensuring precise and comprehensive ICD 10/CCSA coding.

Meeting month-end deadlines.

Verifying accurate and complete billing.

Communicating adequate and pertinent information to medical schemes.

Managing internal DSO and optimizing utilized tools.

Overseeing the complete rollout and adherence to Care Risk Management Procedures and Protocols.

Effectively resolving rejections related to case management.

Cultivating a collaborative and supportive workplace atmosphere, encouraging teamwork, communication, and professional growth among team members.

Keeping abreast of industry trends, regulations, and best practices in case management, ensuring compliance with relevant standards and guidelines.

COMPETENCIES (The following will be advantageous) MINIMUM REQUIREMENTS (Educational Qualifications&Experience)

Relevant Nursing Qualification with Registration with the SANC

Must be computer literate.

Must have Billing / Auditing experience will be advantageous.

Experience in a multidisciplinary hospital environment.

ICD 10 and CCSA coding experience is a requirement.

Must have experience in liaising with medical aids, doctors, and patients.

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