Case Manager

Case Management Melomed Bellville   EQUIREMENTS: ? Qualified Registered Nurse ? Registration with SANC and proof of indemnity cover ? Minimum 2 years? experience ? Previous experience in a private hospital would be advantageous ? Knowledge of ICD 10 and CPT coding ? Knowledge of Prescribed Minimum Benefits (PMB) Scheme rules and policies ? Medical-aid background in Case Management Department ? Excellent communication skills (written and spoken) ? Excellent analytical and problem-solving skills ? Excellent MS Office computer skills, i.e.Outlook, Word, Excel, Kronos, Clinic Manager, etc.? Attention to detail ? Ability to cope well under pressure KEY OUTPUTS: ? Assess patient conditions and needs to develop appropriate care plans ? Interact with patients and medical aid schemes ? Resolve patient and medical aid scheme queries ? Update all information timeously and accurately ? CPT and ICD coding ? Obtain doctors letters, motivations, and justifications in all appropriate cases under managed care of where medical aids request them from their hospitals as part of their assessing process.? Monitor patient admissions and identify those who have limitations, restrictions, place by their managed care/ medical aid structures e.g.length of stay, cost restrictions, fixed fees, per diem and other limiting fees or drugs and/ or formularies.? Maintain a control system that ensures the systematic monitoring of managed care patients.? Handling patient queries.? Update hospital information Case Manager Qualified Registered Nurse ? Registration with SANC and proof of indemnity cover ? Minimum 2 years? experience ? Previous experience in a private hospital would be advantageous ? Knowledge of ICD 10 and CPT coding ? Knowledge of Prescribed Minimum Benefits (PMB) Scheme rules and policies ? Medical-aid background in Case Management Department ? Excellent communication skills (written and spoken) ? Excellent analytical and problem-solving skills ? Excellent MS Office computer skills, i.e.Outlook, Word, Excel, Kronos, Clinic Manager, etc.? Attention to detail ? Ability to cope well under pressure