Case Manager (Hbm)

Case Manager (HBM) Ref: CMHBM/TB Salary: Market related Location: Pretoria Our client, in Managed Care, seeks to employ a Registered Nurse Case Manager with experience in Hospital Benefits Management to deliver cost-effective service to its members. Key requirements: Grade 12. BCUR Degree/ Diploma in Nursing. Active SANC Membership At least 5 years experience as a nursing practitioner with experience in Trauma, ICU or Theatre. Expertise gained as a Case Manager with Hospital Benefits Management. Good understanding of the Medical Schemes Act, clinical terms, ICD 10 codes and Tariff codes. Good analytical and administrative skills. Computer skills and knowledge of Ms Word, Excel, Office, Outlook and Internet. Key responsibilities: Risk Management to reduce the risk associated with hospital and authorised cases. To assist clients by approving appropriate funding within the option benefits, Scheme and clinical protocols Case Management of authorised cases according to the acceptable Scheme rules and protocols. Pended list to be up to date within 30 days. Verify prosthesis limit to contain costs for both members and fund. To deliver an effective call centre service in order to achieve members satisfaction. Required documents: Qualification copies Updated CV Copy of SANC receipt Matric certificate Copy of ID Copy of current payslip To apply, send your supporting documents together with your CV (detailed copy) to ****** or call us on 0860 100 684.
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