Medi Clinic Vacancies – Manager

Website Mediclinic

Job Description:

To coordinate the hospital case management process and facilitate the communication process between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation.

Job Responsibilities:

  • Ensure clinical coding standards are adhered to as per Level 3 coding guideline
  • Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems
  • Ensure correct and timeous finalisation of cases to facilitate reimbursements from funders of claims
  • Lead and manage the people in the Case Management team (if applicable)
  • Minimise financial risk by effectively managing patient stay
  • Consistently and timeously communicate with Funders as contractually agreed through the relevant case management channels

Job Requirements:

  • Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.)
  • Anatomy; physiology and terminology
  • Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.)
  • Authorisation and motivation of Level of Care; Length of Stay; Short Payments etc.
  • Daily workflow; managing deviances; coding; and case management processes
  • Computer literate (Microsoft Office)
  • Scientific nursing principles and process
  • B2B EMS (electronic message system: check status of authorisations and use for trouble,shooting)
  • Funder Contracts; Medical aid requirements/narrations

Qualification & Experience:

  • linical qualification
  • Registered Nurse / Professional Nurse or qualified Paramedic
  • Experience in Theatre and or ICU; Medical aid background; Experience in private healthcare environment or experience as an ILS/ALS Paramedic
  • Minimum of 3 years in a clinical role

Job Details:

Company: Mediclinic

Vacancy Type:  Full Time

Job Location: Worcester, Western Cape, SA

Application Deadline: N/A

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