Closing date: 09/12/2024
Number of positions: 1
Recruiter name: Lynelle Govender
Reference number: 53858
Workplace Type: On-site
Permanent
Please note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profile MAIN 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 Paramedic
REQUIRED EXPERIENCEESSENTIAL MINIMUM EXPERIENCE: Minimum of 3 years in a clinical role
DESIRED EXPERIENCE: Experience in Theatre and or ICU; Medical aid background; Experience in private healthcare environment or experience as an ILS/ALS Paramedic
REQUIRED JOB SKILLS AND KNOWLEDGEAnatomy; physiology and terminologyFunder Contracts; Medical aid requirements/narrationsScientific nursing principles and processB2B EMS (electronic message system: check status of authorisations and use for troubleshooting)Authorisation 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 thereof (Level 3 coding)Patient admin programmes on the AS400 systemAll 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.
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