Assistant Case Management Enrolled Nurse at Sibanye-Stillwater

The Appointee should:

• NQF 5 (Enrolled Nurse, ICD 10 Coder) (Qualifications as approved by the SA Nursing Council).
• At least 3 years Clinical work experience in a health facility/ environment or management health care organization.
• Have proven computer proficiency in MS Office.
• Have strong industry knowledge with ability to extract, organize and capture significant amount of electronic information with the ability to pay attention to details and accuracy.
• Have the ability to work under pressure.
• Professional Registration with the South African Nursing Council.
• Professional Registration with Case management Association of South Africa (CMASA).
• Medical fit to work the specific business area.
• Clear credit record.

Advantageous Qualifications:

• Specialists certificate in Vision/ Audiology/ Spirometry/ HTS.
• Case Management certificate/ Accreditation.

Key Responsibilities:

• Apply, Maintain, and comply with CM standards within the work environment.
• Request patient/ significant other to complete consent form for the services provider/ specialist/ allied service to release medical report and clinical test conducted. (POPIA) and vice versa.
• Analyze and assess the clinical repots for completeness, accuracy and applicable.
• Ensure that ICD 10 Codes and procedure codes (Tariff codes) are provided accurately and appropriately.
• Upload clinical documents onto an applicable Health ICT system. (Vulnerable employees, Mine accidents, Temporary and Permanent Unfit not excluding Medical Incapacity/ ill health retirement cases.
• Comply with requirements of the Quality Management System.
• Participate in risk assessment and take appropriate action.
• Address workplace hazards and risks.
• Registration of patient on relevant case management systems and ensure that clinical information is captured accurately with appropriate diagnose, DRG Coding, ICD 10 Coding and Procedure codes (Case Management clinical updates).
• Resolution of Mne Accident sick notes, clinical reports and analyze clinical sequence of events.
• Assess the employee clocking profile on HR System- Maxxess and capture appropriate mine accident sick leave days onto HR System( Symplexity).
• Upload received clinical report documents onto the relevant system e g, PAS (Providence Administrative System) and Qmed.
• Create Occupational Disease Pre auth as per approval framework and compliance to clinical justification (Referral to meet criteria of the request e g Audiologist, Optom, TEBA for HBC, Stepdown and ad hoc).
• Assist employees (medica schemes) wit ex gratia Preauthorization access and resolve queries / requests regarding rejections / reputation.
• Build and maintaining relationships with stakeholders across the organization and externally at all levels and cross functionally.
• Ensuring open communication channels with all relevant stakeholders.
• Give support and assistance to the Operation CM in getting clinical quotation form service providers and ensure that detailed information is provided for the CM to present it to the Health Management advisory team for approval framework process.
• Participate in driving cost saving and cash conversion initiatives. (Quotations, maintain LOC and LOS guidelines).
• Maintain and comply with SHE standards within the work environment.
• Focus on the safety and health as well as operational excellence.

Deadline:17th March,2026