Available Vacancies at Clinix Health Group (Pty) Ltd

Job Description

To plan, coordinate and execute case management work at hospital level. The incumbent utilities clinical knowledge to minimise financial risk and ensure accurate billing through comprehensive accurate coding of patient care.

Minimum Requirements:

• Nursing Diploma.
• CM or Billings Clerk with ICD training and anatomy and physiology course certification.
• IDC and CPO coding.
• 3-5 years’ experience as a hospital case manager. 
• Understanding of diagnostic related groupers

Minimum work experience:

• Liaise with Receptionist for authorisations.
• Ensure compliance to case management procedures, standards and protocols.
• Plan, coordinate and execute Clinical coding in accordance with relevant CHG standards and protocols.
• Ensure accurate, appropriate and complete diagnostic and procedural coding of all patient records in the hospital.
• Timeously and consistently communicate and follow up with Funders (Medical Aids, COID, Government, RAF, DOL, etc.).
• Provide appropriate clinical information to Funders in order to update Length of Stay, Level of Care, formulary utilisation, assistive devices / Prosthesis, diagnostic interventions, therapy intervention and procedural interventions and required change in the facility.
• Consult daily with all relevant health care providers with regards to patient treatment.
• Ensure the maintenance of patients’ clinical status (subsequent interventions and treatments) in accordance to Funder requirements for the duration of hospitalisation.
• Ensure the correct categorisation and management of different patient accounts to facilitate reimbursement by Funder.
• Ensure accurate and timeous finalisation of cases to facilitate reimbursement by Funders.
• Minimise financial risk by the effective management of patient hospitalisation.
• Follow the established and approved escalation processes in the event of a decline of payment by Funder.
• Ensure to remain in the group and facility targets of 3 days for WIP (work in progress) and DNYB (discharged not yet billed).

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Minimum Qualifications and Experience:

• Diploma in Finance / Accounting / Bookkeeping or related Finance qualification or certificate Enrolled Nursing qualification.
• 1-2 years’ experience overall work experience in either Finance or Healthcare.
• Finance or Reporting system experience.
• Computer literacy
• Report writing
• Data analysis

Minimum Job Requirements:

• Efficient management of financial processes.
• Responsible for daily banking for Pharmacy and Reception utilising approved systems.
• Identify and highlight variances in accounts and recorded information then escalate for rectification.
• Investigate and resolve enquiries with invoicing and ensure the accurate maintenance of supplier invoices.
• Procurement administration.
• Oversee stationery and consumables stock control for facility.
• Ensure all monthly supplier invoices are processed and captured for payment, timeously.
• Maintenance of asset register.
• Process Pharmacy Invoices.
• Deliver finance processes as per the Hospital Operating plan.
• Identify and manage problems and escalated issues.

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Job Summary:

To learn and manage delivery of Clinical performance across the Group to optimize quality care standards. The incumbent is additionally responsible for the delivery of the Clinical department’s work within time, budget and comply with specifications and quality standards.

Minimum Qualifications and Experience:

• Masters Degree in Public Health or Business Administration.
• 5-7 years’ experience in a similar role.
• Current registration with the HPCSA.

Minimum Job Requirements:

• Deliver on the Clinical function’s operating plan.
• Lead and implement tactical strategies for all CHG hospitals.
• Implement, monitor and control clinical processes according to quality standards, policy, compliance and governance requirements.
• Ensure the development, alignment, mapping and implementation of standard operating procedures and processes across all CHG hospitals.
• Review and audit (on a rotational basis) existing processes (relevant to the Clinical function) to streamline processes, drive efficiencies, minimise redundancies and overall management of clinical risk.
• Provide guidance and support in terms of Clinical matters to relevant Allied and Clinical professionals across all CHG hospitals.
• Actively collaborate with relevant clinical risk functions and forums to drive Clinical and Quality measures.
• Develop and review relevant policies in collaboration with clinical leads and ensure all approved documents meet CHG, regulatory and industry standards and requirements.
• Lead the design and implementation of new Clinical products and services.
• Observe hospital sites for clinical safety, ensuring all work is performed according to quality standards.
• Escalate continuous non-conformance to management (Hospital and Head Office).
• Put mitigating processes in place for retaining and corrective standards actions if any unsafe actions are identified.