Case Manager (Registered Nurse) at Private Hospital in Mahikeng
Glasshouse Recruiting · Mahikeng, North West
Overview
A private hospital group in Mahikeng is looking for a Registered Nurse with case management experience to join their team. You will play a key role in coordinating patient care, communicating with medical schemes, and ensuring accurate clinical information to minimise financial risk. If you have 3 to 5 years of experience in a hospital or medical scheme setting and know your way around ICD-10 and CPT coding, this permanent full time position could be a great fit.
About the role
As a Case Manager at this private hospital in Mahikeng, you will be responsible for delivering an effective case management process and facilitating communication between all role players. Your main goal will be to provide accurate and timely clinical information to minimise financial risk for the company.
Key duties include:
- Ensuring authorisations on admissions are accurate on the SAP system daily
- Conducting daily case management rounds in allocated units to gather updated clinical information from patient files
- Complying with case management procedures, medical scheme contracts and legal aspects using available resources and systems
- Communicating consistently and timeously with medical schemes through the agreed channels
- Obtaining doctors letters of motivation when requested by medical schemes
- Minimising financial risk by effectively managing patient stay
- Communicating daily statistics with Billings regarding files with case management
- Resolving queries related to short payments from medical schemes in conjunction with the Collections Department
This is a permanent full time position based at a hospital in Mahikeng.
Requirements
- Grade 12 (Matric)
- Registered Nurse, currently registered with SANC
- Certificate in Coding is advantageous
- 3 to 5 years experience in a private hospital or medical scheme environment in a case management capacity
- Working knowledge of ICD-10 and CPT codes
- Computer proficiency in SAP System or similar
Responsibilities
- Ensure authorisations on admissions are accurate as per SAP system on a daily basis
- Conduct daily case management rounds in allocated units to obtain updated clinical information from patient files
- Comply with case management procedures, medical scheme contracts and legal aspects by utilising available resources and systems
- Communicate consistently and timeously with medical schemes as contractually agreed through the relevant case management channels
- Obtain doctors letters of motivation in support of cases where medical schemes request them
- Minimise financial risk by effectively managing patient stay
- Communicate daily statistics with Billings regarding number of files with case management to progress files through the system quickly and achieve discharge to final bill targets
- Resolve queries related to short payments by medical schemes in conjunction with the Collections Department
Job details
- Organisation
- Glasshouse Recruiting
- Location
- Mahikeng, North West
- Job type
- Full time
- Experience level
- Mid (3+ years)
- Education
- Certificate
- Category
- Healthcare & Nursing
- Application Method
- Apply online
Success Guide
Hello there! This role is perfect for a Registered Nurse with a few years of case management experience under your belt. When applying, make sure your CV clearly shows your SANC registration and highlights your experience working with ICD-10 and CPT codes. They also want someone comfortable using systems like SAP, so mention that if you have it. A certificate in coding will give you an edge. In the interview, be ready to talk about how you have managed patient stays to reduce financial risk and how you communicate with medical schemes. Show that you are organised, detail oriented and a strong communicator. Good luck!
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