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Lenmed invites suitably qualified candidates to apply for the following position

Senior Case Manager X 2 I Based in Durban KZN

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DEPARTMENT

Patient Services

JOB TITLE

Senior Case Manager X 2 I Based in Durban KZN

CLOSING DATE

2026/10/06

HOSPITAL

Lenmed Head Office

WORK ADDRESS

Lenmed Head Office - 2nd Floor, Building, 9 Lakeview Ave, Weltevredenpark, Roodepoort, 1709

Main Focus Areas

The incumbent will be responsible for providing on-site and remote support during peak periods, staff shortages and operational challenges, ensuring continuity and stability of patient services. The role will provide targeted business deployment and operational support across all Lenmed hospitals in Durban, KwaZulu-Natal, with a specific focus on stabilising case management operations, enhancing operational capacity and driving sustained performance improvement within high-demand or underperforming environments. The role is responsible for ensuring the consistent delivery of efficient and standardised case management processes, underpinned by robust quality assurance, adherence to organisational policies and procedures, regulatory compliance, and sound financial governance. In addition, the role will retain a focused operational case management component to ensure continuity of service, maintain critical clinical and funding insights, and enable the proactive identification, escalation and resolution of systemic inefficiencies. The incumbent will work closely with hospital management, case management teams and relevant stakeholders to identify operational gaps, implement appropriate interventions and support    

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

  • Provide on-site and remote operational support across Lenmed hospitals KwaZulu Natal during peak periods, staff shortages and operational challenges.
  • Provide targeted business deployment and case management support to facilities requiring additional operational intervention.
  • Rapidly assess case management operations upon deployment and identify gaps, risks and priority areas requiring immediate attention.
  • Stabilise and optimise case management processes in line with organisational policies, SOPs, funder requirements and regulatory standards.
  • Ensure continuity and stability of patient services during periods of increased operational demand.
  • Coordinate multidisciplinary care by facilitating daily ward rounds and effective collaboration between clinical, nursing and administrative teams.
  • Monitor PAAS scoring and appropriate levels of care to ensure clinical appropriateness and consistency.
  • Identify, prioritise and actively manage high-risk and high-cost cases.
  • Ensure timely and accurate clinical updates, including required turnaround times such as 8-hour updates, to support funding approvals and clinical decision-making.
  • Oversee and support authorisation processes, ensuring cases are clinically and financially justified.
  • Proactively manage funder escalations in accordance with relevant escalation matrices.
  • Support accurate and compliant clinical coding, ensuring alignment between clinical documentation, coding and billing requirements.
  • Maintain critical clinical and funding insights to support operational and financial decision-making.
  • Analyse case management trends, rejections, operational inefficiencies and systemic challenges, implementing corrective actions where required.
  • Drive sustained performance improvement by identifying opportunities to strengthen capacity, processes and team capability.
  • Promote standardised case management practices and ensure consistent implementation across facilities.
  • Facilitate effective communication with treating doctors, funders, hospital management and multidisciplinary teams.
  • Manage and resolve funder queries, high-risk cases and operational challenges proactively.
  • Strengthen team capability through coaching, guidance, knowledge sharing and promotion of best practices.
  • Drive compliance with clinical governance, quality assurance and regulatory requirements.
  • Support safe, effective and patient-centred care delivery.
  • Prepare and submit deployment reports outlining key findings, identified risks, interventions implemented, outcomes and performance improvements achieved.

Post Requirements: (include but are not limited to)

Minimum Required Education
  • B Degree in Nursing (NQF 6) or equivalent.
  • Current SANC registration, or relevant allied health registration.
  • Advanced computer literacy and high accuracy in clinical and billing systems.
  • 3–5+ years acute hospital experience.
  • 3+ years in case management, managed care, or patient flow.
Inherent Requirements
  • Proven experience in case management and clinical coding within a hospital environment
  • Strong knowledge of medical aid rules and hospital billing processes
  • Experience in managing financial risk and DNYB
  • Computer literacy (Microsoft Office); SAP/Kronos advantageous5 years case management experience in a multi-disciplinary hospital
  • Strong understanding of medical aid rules and funding protocols
  • Case management and revenue cycle processes
  • Clinical coding (ICD-10, CPT/CCSA)
  • Advanced ICD-10 Qualification

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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