Case Manager - Mitchells Plein Full job description Requirements:� Qualified Registered Nurse� Both need to registered with SANC and proof of indemnity cover� Minimum 3 years nursing experience in a multidisciplinary hospital.� Experience and exposure in Theatre and/or ICU would be advantageous� Hospital or Medical Aid scheme case management would be an advantage.� Experience in ICD 10 and CPT coding is essential� Knowledge of Prescribed Minimum Benefits (PMB) Scheme rules and policies� Excellent communication skills (written and spoken)� Excellent analytical and problem-solving skills� Excellent MS Office computer skills, i.e. Outlook, Word, Excel, Kronos, Clinic Manager, etc.� Attention to detail� Ability to cope well under pressureKey Outputs:� Assess patient conditions and needs to develop appropriate care plans� Interact with patients and medical aid schemes� Resolve patient and medical aid scheme queries� Update all information timeously and accurately� CPT and ICD coding� Obtain doctors letters, motivations, and justifications in all appropriate cases under managed care of where medical aids request them from their hospitals as part of their assessing process� Monitor patient admissions and identify those who have limitations, restrictions, place by their managed care/ medical aid structures e.g. length of stay, cost restrictions, fixed fees, per diem and other limiting fees or drugs and/ or formularies� Maintain a control system that ensures the systematic monitoring of managed care patients� Handling patient queries� Update hospital informationInterested applicants are requested to submit their applications with an updated, comprehensive CV, including a picture and supporting documents to mmprecruitment@melomed.co.za by Friday, 22 March 2024.
