Specialist: Case Manager at AfroCentric Group

Job description

Key Role: To ensure clinical appropriateness of care at lowest possible cost without compromising quality of care. To use appropriate tools such as Burden of Care Criteria in the application of discharge planning. To manage the risk to the client by assessing the quality of information received and sent out and anticipating the cost of the scheme. To recognise the skills and the resources available to facilitate a successful recovery

Core Tasks:

• Follow procedures and cooperate with peers and leader for best possible service delivery
• Identify treatment trends and patterns to manage clinical and financial risk
• Contribute to cost savings within the department to assist with financial goals and target
• Ensure clinical approval of authorised treatment plan
• Ensure the cost effective management of authorised treatment plan
• Ensure appropriate and cost effective out of hospital care for members
• Perform quality updates of system to ensure correct payments of treatment
• Attend to High Level Queries and ex-gratia updates
• Meet delivery objectives through working with other team members within and linked to the department/project
• Resolve operational performance variations and problems and escalate unresolved issues to higher levels
• Ensure delivery targets/objectives are met and operate in a supportive manner to achieve successful delivery
• Ensure appropriate, active and informative relationships with customers and relevant stakeholders are successfully achieved

The ideal candidate will have:

• Degree or Diploma in Nursing and Midwifery
• Intensive Nursing Care qualification
• SANC professional nursing registration
• 2 years ICU experience
• 3 years ward experience

Please note that if you have not heard from us in 2 weeks, accept your application as unsuccessful.