Case Manager at Western Cape Department of Health and Wellness

REQUIREMENTS :

• Minimum educational qualification: Appropriate three-year health related National Diploma/Degree or equivalent registrable with the Health Professions Council of South Africa (HPCSA) or South African Nursing Council (SANC).

Experience:

• Appropriate experience in a Case Management/Medical Aid environment.
• Appropriate experience in ICD-10 Code assignment and the ability to link patient diagnosis with procedural codes.

Inherent requirement of the job:

• Valid (Code B/EB) driver’s licence.

Competencies (knowledge/skills):

• Ability to work with Excel spread sheets, Microsoft Word and web-based programs (medical aids). Good knowledge of the Uniform Patient Fees Schedule (UPFS), Managed Health Care or Hospital Information Systems and EDI (Electronic Data Interchange). Knowledge of the Medical Schemes Act 131 of 1998 and the application of Prescribed Minimum Benefit (PMB) legislation i.e. the Chronic Disease List (CDL) and Diagnostic Treatment Pairs (DTP)