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Case Manager
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Employment Type: Permanent
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Reference No: MHS28/2021
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Western Cape Rehabilitation Centre, Chief Directorate: Metro Health Services
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| A health-related qualification registrable with the Health Professions Council of South Africa (HPCSA) or South African Nursing Council (SANC). |
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| Ability to communicate in at least two of the three official languages of the Western Cape. The ability to work with Excel spread sheets, Microsoft Word and web-based programs (medical aids). Good knowledge of the Uniform Patient Fees Schedule (UPFS), Managed Health Care or Hospital Information Systems and EDI (Electronic Data Interchange). Knowledge of the Medical Schemes Act 131 of 1998 and the application of Prescribed Minimum Benefit (PMB) legislation i.e. the Chronic Disease List (CDL) and Diagnostic Treatment Pairs (DTP). |
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| Appropriate experience in Case Management/Medical Aid environment. Experience in ICD-10 Code assignment and the ability to link patient diagnosis with procedural codes. |
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| Mr A Kannemeyer, tel. no. (021) 370-2318. |
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| Responsible for the management and implementation of Case Management policies, protocol and procedures in the hospital. Perform operational Case Management functions inclusive of pre-authorisation and clinical review to ensure compliance with Case Management policies and procedures. Conduct clinical audits of patient accounts to ensure accuracy of invoices for submission to medical aids and state departments. Provide support to the hospital Fees Department in terms of follow-up of outstanding medical scheme and state department balances and account queries. Assist with EDI rejections to ensure timeous submission of medical scheme invoices. Provide quotations to H1, H2, H3 and Foreign patients. |
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| Valid (Code B/EB) driver’s licence. |
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Remuneration:
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R 316 791 - R 373 167 per annum Annual salary plus service benefits (13th cheque, employer's contribution to the pension fund, housing and medical aid allowance).
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Starting Date:
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2/19/2021 12:00:00 AM
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NOTICE TO ALL
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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.
All shortlisted candidates, including SMS, shall undertake two pre-entry assessments. One will be a practical exercise to determine the candidate’s suitability based on the post’stechnical and generic requirements, and the other will be an integrity (ethical conduct)assessment.
- 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.
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This advertisement may be utilized to create the pool of potential candidates for a period of not more than 3 calendar months from the date of the advertisement to fill any vacancy in the Department of Health and Wellness provided that the job title, core functions, inherent requirements, and salary level are the same as those of the advertised post.
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Closing date: 3/12/2021 12:00:00 AM
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