Senior Case Manager for Hospital Group in Durban, KwaZulu Natal
Glasshouse Recruiting · Durban, KwaZulu Natal
Overview
Glasshouse Recruiting is looking for a Senior Case Manager to provide operational support across a hospital group in Durban, KwaZulu Natal. You will stabilise case management processes, manage high risk cases, and drive performance improvement in a permanent full time role. If you have strong clinical coding and medical aid knowledge, this could be a great fit.
About the role
As a Senior Case Manager, you will provide on site and remote support to hospitals across Durban during peak periods, staff shortages, and operational challenges. Your goal will be to keep patient services running smoothly and to strengthen case management where it is needed most.
You will assess operations quickly when deployed, identify gaps and risks, and put practical interventions in place. You will also carry a focused case management load to stay close to clinical and funding details and to spot systemic inefficiencies early.
Key duties include:
- Stabilising and optimising case management processes in line with policies and funder requirements
- Facilitating daily ward rounds and coordinating care across clinical, nursing, and administrative teams
- Monitoring PAAS scoring and appropriate levels of care
- Managing high risk and high cost cases and ensuring timely clinical updates
- Overseeing authorisation processes and proactively managing funder escalations
- Supporting accurate clinical coding and compliance with billing requirements
- Analysing trends, rejections, and inefficiencies and implementing corrective actions
- Coaching and guiding case management teams to strengthen capability
- Preparing deployment reports on findings, interventions, and outcomes
Requirements
- B Degree in Nursing (NQF 6) or equivalent
- Current SANC registration or relevant allied health registration
- Advanced computer literacy with high accuracy in clinical and billing systems
- 3 to 5+ years of acute hospital experience
- 3+ years in case management, managed care, or patient flow
- 5 years case management experience in a multi disciplinary hospital
- 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 in Microsoft Office (SAP and Kronos advantageous)
- Strong understanding of medical aid rules and funding protocols
- Knowledge of case management and revenue cycle processes
- Clinical coding knowledge (ICD 10, CPT/CCSA)
- Advanced ICD 10 Qualification
Responsibilities
- Provide on site and remote operational support across hospitals in KwaZulu Natal during peak periods, staff shortages, and operational challenges
- Assess case management operations on deployment and identify gaps, risks, and priority areas
- Stabilise and optimise case management processes in line with policies, SOPs, funder requirements, and regulatory standards
- Ensure continuity and stability of patient services during increased operational demand
- Coordinate multidisciplinary care by facilitating daily ward rounds and collaboration between clinical, nursing, and administrative teams
- Monitor PAAS scoring and appropriate levels of care for clinical appropriateness
- Identify, prioritise, and actively manage high risk and high cost cases
- Ensure timely and accurate clinical updates, including 8 hour updates to support funding approvals
- Oversee and support authorisation processes to ensure cases are clinically and financially justified
- Proactively manage funder escalations in line with escalation matrices
- Support accurate and compliant clinical coding aligned with documentation and billing
- Maintain critical clinical and funding insights for operational and financial decisions
- Analyse case management trends, rejections, and inefficiencies and implement corrective actions
- Drive sustained performance improvement by strengthening capacity, processes, and team capability
- Promote standardised case management practices across facilities
- Facilitate communication with treating doctors, funders, hospital management, and multidisciplinary teams
- Resolve funder queries, high risk cases, and operational challenges proactively
- Strengthen team capability through coaching, guidance, and knowledge sharing
- Drive compliance with clinical governance, quality assurance, and regulatory requirements
- Prepare and submit deployment reports on findings, risks, interventions, outcomes, and improvements
Job details
- Organisation
- Glasshouse Recruiting
- Location
- Durban, KwaZulu Natal
- Job type
- Full time
- Experience level
- Senior (3+ years)
- Education
- Bachelor
- Category
- Healthcare & Nursing
- Application Method
- Apply manually
Success Guide
When applying for this Senior Case Manager role, highlight your experience in hospital case management and clinical coding. Be ready to discuss specific examples of how you have managed high risk cases and worked with medical aids. Make sure your SANC registration is current and that your CV clearly shows your acute hospital experience and coding qualifications. This role involves travel between hospitals in Durban, so mention your ability to be flexible. In an interview, you might be asked about how you handle funder escalations and how you ensure compliance with coding standards. Show that you can coach and support other team members. Good luck!
How we help you prepare
This employer takes applications on their own website, so you'll submit this one yourself — but SPAAN NOW gets everything ready for you first. Here's how it works:
- Our AI tailors your CV to match this job's keywords and requirements, so it stands out to recruiters and screening systems.
- A custom cover letter is written specifically for this role — no generic templates.
- We gather the documents this job needs: CV, Degree certificate and Professional registration. SPAAN NOW pulls these from your profile and packages them together, ready to attach.
- Once your application is prepared, we show you exactly how and where to apply — just follow the link to the employer and submit your ready-made CV, cover letter and documents.
- Mark it as applied under Applications to keep track, and if you're shortlisted, use AI Interview Prep to practise questions commonly asked for roles like this.
We do the hard part — tailoring and gathering everything — so applying yourself only takes a minute.
Spaan Talk
Nobody has said anything yet. Be the first.