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Vacancy Details
 
A job opportunity

A job opportunity exists for the right candidate in Western Cape
The Department of Health and Wellness is guided by the principles of Employment Equity. Candidates with disabilities are encouraged to apply and an indication in the regard will be appreciated.

Note: No payment of any kind is required when applying for any of the positions advertised by the Western Cape Government.
 
Case Manager
  Employment Type: Permanent
  Reference No: GSH119/2025
  Groote Schuur Hospital
 
Experience:
Appropriate experience in liaison with medical aid (funders) and managed care organisations with regards to MHC policies, protocols, optimal fund utilisation and updated clinical information. Appropriate experience in Case Management/Medical Aid Environment. Appropriate experience in ICD 10 codes assigned.
 
Minimum educational qualification:
Appropriate three-year health related National Diploma/Degree registrable with the Health Professions Council of South Africa (HPCSA) or South African Nursing Council (SANC).
 
Competencies (knowledge/ skills):
Knowledge of the Uniform Patient Fees Schedule, Hospital Information Systems and EDI (Electronic Data Interchange). Knowledge of Medical Aid Act 131 of 1998 and the application of Prescribed Minimum Benefit (PMB) legislation i.e. the Chronic Disease List (CDL) and the Diagnostic Treatment Pairs (DTP). Ability to work with MS Excel and Web-based Programmes (medical aids). Ability to link patient diagnosis with procedure codes.
 
Enquiries:
MR TJ Langenhoven Tel no 021 404 2358.
 
Note:
No payment of any kind is required when applying for these posts. Candidates will be subjected to a competency test.
 
Duties (Key result areas/outputs):
Perform hospital Case Management functions wrt authorisation, benefit management, and review of clinical information for externally funded clients. Co-ordinate the workflow process between clinical and admin personnel supporting various role players within the hospital wrt ICD-10 codes, prescribed minimum benefits and account queries. Conduct clinical audits of Medical Aids and State Department, eg. RAF and COIDA to ensure accuracy of invoices. Implement Case Management policies, protocols and procedures within the hospital. Provide quotations to privately funded and foreign patients and compile statistical reports. Supervision of staff and liaison with relevant role players in matters relating to Case Management. Relief colleagues.
 
 
 
 
Remuneration:
R 397 116 per annum Annual salary plus service benefits (13th cheque, employer's contribution to the pension fund, housing and medical aid allowance).
 
Starting Date:
7/11/2025 12:00:00 AM
 
NOTICE TO ALL
Candidates may be subjected to a competency test. No payment of any kind is required when applying for this post. As directed by the Department of Public Service and Administration, applicants must note that further checks will be conducted once they are shortlisted and that their appointment is subject to positive outcomes on these checks, which include security clearance, qualification verification, criminal records and previous employment.
  • It will be expected of shortlisted candidates to be:
  • available at the venue on the time and date as determined by the Department and
  • bring along recently (not older than 6 months) certified copies of your Identity Document (ID), driver’s license (if applicable for the post), qualification and/or proof of registration at relevant statutory body. Failure to adhere to the aforementioned may lead to his/her application being disqualified and not further considered.
Closing date: 7/25/2025 12:00:00 AM
 
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