Case Manager
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Employment Type: Permanent
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Reference No: OD8/2019
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Swellendam Hospital
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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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Appropriate experience in Case Management or Medical Aid environment. |
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Flexible with regards to working of official hours. Valid driver’s license. |
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Knowledge of the Uniform Patient Fees Schedule, Hospital Information Systems, EDI (Electronic Data Interchange), experience in ICD 10 codes assigned and the ability to link patient diagnosis with procedure codes. Knowledge of the 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), RAF and other state departments. Ability to work with MS Excel and Web-based Programmes (medical aids). Excellent written and verbal communication in at least two of the three official languages of the Western Cape. |
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Ms E Whittles, tel. no. (028) 514-8400 |
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Only applicants within the Provincial Government: Western Cape will be considered for this post. |
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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 and the provision of quotes. Provide support to the hospital Fees Department in terms of follow-up of outstanding medical scheme and state department balances, account queries and provide quotations to H2, H3 and Foreign patients. Assist with EDI rejections to ensure timeous submission of medical scheme invoices. Assist Hospital Management in the distribution of Quality Client Care and compilation of statistical reports. |
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Remuneration:
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R 316 791 per annum - 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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9/20/2019 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.
- 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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Closing date: 10/11/2019 12:00:00 AM
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FOR YOU
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