Case Manager: Acute Rehab at Busamed Hospital Group

The Case Manager will be responsible for the liaison between the patient and medical aids in order to secure payment for the hospital.

Requirements

• Grade 12 or equivalent NQF level 4 qualification
• Diploma in Nursing Qualification is essential/ SANC registration is compulsory 

Work Experience

• Previous Case Management in Acute Rehab experience is advantageous
• ICD & CPT Coding would be advantageous 

Knowledge

• Intermediate computer skills
• Excellent interpersonal and communication skills
• Knowledge of Medical aids
• Ensuring all the relevant details on Hospital Billing System are updated and are accurate
• Supply all details regarding the patients’ history to Clinical partners
• Monitor and control costs for Managed Care Organization patients
• Confirm length of stay for all Managed Care Organization patients
• Accompany Managed Care Organization Case Managers on ward rounds in the hospital
• Assist with final authorization of Managed Care patient files
• Ensure correct coding for all Managed Care Organization patients
• Consult with the relevant services providers regarding the patient care treatment
• Assist with the transfer of patients to Rehab hospital or step down facilities
• Arrange in-service training for relevant staff to meet the needs of the theatre department
• Liaise network of internal and external stakeholders to ensure that managed care of patients is maintained
• Actively participate as a member of a team to achieve goals
• Active involvement in own professional development to maintain a satisfactory level of skill and knowledge
• Work effectively and co-operatively with others to establish and maintain good working relationships that are mutually beneficial
• Develop collaborative relationships to help accomplish work goals and targets