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Johannesburg: Case Manager posted by Palesa Mbali Group






Date 2024-07-07
Job Title Case Manager
Employer Palesa Mbali Group
More Information
Salary 0
Category Medical
Location Gauteng
/ Johannesburg

Job Summary

Case Manager

Position:

Case Manager

Department:

General and Specialized Case Management

Grade:

B4M1

Position Purpose:

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 for the scheme. To recognize the skills and the resources available to facilitate a successful recovery.

Experience:

5 years ward experience, 2 years experience hospital scheme case management advantageous

Qualifications:

Degree / Diploma in nursing, midwifery, and psychiatry. Current SANC professional nursing registration. Proof of registration to be provide.

Generic Objectives:

  • Compliance and Risk Management:
  • Identify treatment trends and patterns to manage clinical and financial risk.
  • Ensure clinical approval of authorized treatment plan.
  • Ensure the cost-effective management of authorized 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

Knowledge

  • Knowledge and application of dispensing of meds, surgical material & procedures
  • Application of financial and risk assessment methodology
  • Knowledge of scheme rules and contractual negotiations
  • Application of clinical intervention principles
  • Advise on best practice health risk solutions to relevant parties
  • Knowledge and application of relevant legislation
  • Knowledge and application of processes and procedures

Skills:

  • Computer Technology Skills
  • Task Management
  • Adobe Creative Suite
  • Data modelling and evaluation
  • Communication Skills
  • Business Writing Skills
  • Relevant systems knowledge and application
  • Ability to negotiate and influence.
  • Problem solving and decision-making skills.
  • Numerical Ability
  • Customer Focus
  • Attention to Accuracy and Detail

Case Manager position available in Gauteng, Johannesburg. This job position was posted by Palesa Mbali Group. The job has been posted as a premium ad on 2024-07-07 at 13:14:33 in the Medical category

Click Go Apply to apply online!

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Posted in Jobs in Gauteng, Jobs in Johannesburg

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Johannesburg: Case Manager posted by Palesa Mbali Group






Date 2024-07-07
Job Title Case Manager
Employer Palesa Mbali Group
More Information
Salary 0
Category Medical
Location Gauteng
/ Johannesburg

Job Summary

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 for the scheme. To recognize the skills and the resources available to facilitate a successful recovery.

Key Activities

  • Identify treatment trends and patterns to manage clinical and financial risk
  • Defined legal, statutory, and regulatory compliance is maintained at the required standards
  • Operational risk and governance structures, measures and frameworks are complied with and necessary action is taken to address issues, when necessary
  • 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 extrait updates

Skills

  • Computer Technology Skills
  • Task Management
  • Adobe Creative Suite
  • Data modelling and evaluation
  • Communication Skills
  • Business Writing Skills
  • Relevant systems knowledge and application
  • Ability to negotiate and influence
  • Problem solving and decision making skills
  • Numerical Ability
  • Customer Focus
  • Attention to Accuracy and Detail

Experience and Qualifications

5 years ward experience, 2 years experience hospital scheme case management advantageous. Degree / Diploma in nursing, midwifery, and psychiatry. Current SANC professional nursing registration. Proof of registration to be provided.

Company Description A formidable healthcare company that aims to deliver exceptional services.

Case Manager position available in Gauteng, Johannesburg. This job position was posted by Palesa Mbali Group. The job has been posted as a premium ad on 2024-07-07 at 13:14:15 in the Medical category

Click Go Apply to apply online!


You might also like to look at the available jobs in the same area.

Apply directly on jobmail for this position
Some posts have contact information included with other instructions. All applicants are urged to read the instructions carefully.
We will list jobs at the bottom of each job, so feel free to scroll down and continue your search.

We do not accept any job applications and merely offer the service of daily jobs being mined and displayed on our job portal.
Each job post has a link to take you directly to the original post to apply on their website or the original website where the post came from.


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Port Elizabeth: Medical / Managed Care Case Manager (Ee)

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Cape Town: Case Manager – Medical Advisor posted by Palesa Mbali Group

Position Purpose:To facilitate the setting of quality standards, policies, and procedures (clinical and non-clinical) for area. Ensure adherence to audit requirements, reporting and planning through evaluation, and coaching internal resources.Experience:5


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Johannesburg: Case Manager posted by Palesa Mbali Group

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 qu

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Case Manager: Physiotherapist Chronic Medicine Management and aPMBGradeB4M1Position PurposeReporting to the PMB Supervisor, the role incorporates the evaluation of ambulatory PMB applications in line with reimbursement guidelines, communication with health


View Job
Case Manager

Cape Town: Case Manager In Hospital posted by Palesa Mbali Group

Position:Case Manager In HospitalPosition Purpose:To coordinate care in allocated facilities, in order to improve health outcomes and manage the cost to the Scheme(/s). The case manager`s responsibilities start from patient admission to discharge and they


View Job
Case Manager In Hospital

Johannesburg: Case Manager posted by Palesa Mbali Group

Case ManagerPosition:Case ManagerDepartment:General and Specialized Case ManagementGrade:B4M1Position Purpose:To ensure clinical appropriateness of care at lowest possible cost without compromising quality of care. To use appropriate tools such as Burden o


View Job
Case Manager

Johannesburg: Case Manager In Hospital posted by Palesa Mbali Group

Position:Case Manager In HospitalPosition Purpose:To coordinate care in allocated facilities, in order to improve health outcomes and manage the cost to the Scheme(/s). The case manager`s responsibilities start from patient admission to discharge and they


View Job
Case Manager In Hospital

Centurion: Insurance Compliance And Contracts Manager (Law Degree Caseware Sage Intact),

Insurance Compliance and Contracts Manager (Law degree Caseware Sage Intact), Centurion, R500 – 1.2k ctc Bachelor of Law Degree 5 years’ post degree experience Certificate in area of Governance, Risk and Compliance. King Code on Governance Principles for


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Error making API request.

Share this to someone who needs a job:
Posted in Jobs in Gauteng, Jobs in Johannesburg

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