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Lenmed invites suitably qualified candidates to apply for the following position

Case Manager

DEPARTMENT

Case Management

JOB TITLE

Case Manager

CLOSING DATE

2024-07-16

HOSPITAL

Royal Hospital and Heart Centre

WORK ADDRESS

Royal Hospital and Heart Centre - Cnr Welgevonden Street and Jacobus Smit Avenue, Royldene, Kimberley, Northern Cape

Main Focus Areas

  • Conducting ward rounds on identified patients to obtain clinical information from patient files.
  • Liaising with Nursing staff, Doctors, and Fund Case Managers.
  • Responsibility for substantiating patient hospitalisation in terms of treatment, length of stay, and level of care.
  • Monitoring and action risk related to medical aid benefits and hospitalisation.
  • Ensuring accurate, specific, and comprehensive clinical coding.
  • Timely, effective communication and follow up with medical aids.

Key Performance Areas: (include but are not limited to)

  • Reviewing authorisation aspects approved and escalating when necessary.
  • Auditing LOS/LOC and releasing the case for billing.
  • Effective communication to medical schemes and adhering to the standards contained in the NHN Managed Health Care rules of engagement.
  • Compliance with all industry-relevant legislative acts, regulations, and circulars.

Post Requirements: (include but are not limited to)

  • Nursing or Case Management qualification/experience
  • Case Management experience: Hospital/Funder
  • Non-Clinical or Assistant Case Manager
  • Clinical nursing/ Managed Healthcare experience
  • ICD-10 / CPT Coding Qualification or experience
  • SAP IS-H experience advantageous
  • Proficiency in Microsoft Office products

Please Note:

Candidates must ensure that their contact details are correct and that they can be contacted during office hours. If candidates are not contacted within thirty (30) days after the closing date, they should consider their applications as being unsuccessful. Late, incomplete and applications not indicating the applicable position will not be considered. The right to fill the position within the Operational requirements of the Company is reserved. By applying for this position and providing us with your CV and other personal information, you are consenting to the information being used for the specific purpose for which it was provided, which is recruitment purposes and possible appointment purposes(should you be successful). Please note that your information will be processed for recruitment purposes only or for such purposes relating to assessing the establishment of an employment relationship with yourself, and this will be in accordance with the applicable data protection and privacy legislation. We confirm that such information will not be used for any other purpose without obtaining your prior consent. If your application is not successful, we retain your CV and other information provided of 6 months after which it will be destroyed in a secure manner. If you object to your information being used in accordance with the aforementioned clauses, please indicate your objection and we will immediately destroy your personal information in a secure manner. Equal opportunity is supported by the Employer.

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