Case Manager – Hospital Full Time

RPO’s client is actively seeking a dedicated and detail-oriented Case Manager to join their team at a reputable private hospital. This is an exciting opportunity for a Registered Nurse with strong administrative and clinical insight into managed care processes. The successful candidate will ensure that patient treatment aligns with managed care requirements, hospital standards, and cost targets. This is a full-time, onsite position.

Responsibilities:

• Assess patient conditions and develop appropriate care plans.
• Engage with patients and medical aid schemes to resolve queries.
• Manage CPT and ICD-10 coding accurately and timeously.
• Obtain doctors’ letters, motivations, and justifications where required.
• Monitor patient admissions and identify medical aid restrictions (e.g. length of stay, cost limits, drug formularies).
• Maintain control systems for the systematic tracking of managed care patients.
• Handle patient-related administrative tasks and update hospital systems accordingly.

Requirements:

• Qualified Registered Nurse (ENs with relevant experience may also be considered).
• Registered with SANC and possess proof of indemnity cover.
• Minimum of 3 years’ nursing experience in a multidisciplinary hospital environment.
• Previous exposure to Theatre and/or ICU advantageous.
• Experience in hospital or medical aid case management is highly desirable.
• Proficient in ICD-10 and CPT coding.
• Strong knowledge of Prescribed Minimum Benefits (PMBs) and scheme rules.
• Excellent verbal and written communication skills.
• Skilled in MS Office (Outlook, Word, Excel), Clinic Manager, Kronos, etc.
• High attention to detail and ability to perform under pressure.

You can also contact RPO Recruitment for your next career-changing move.

Visit the RPO Recruitment website: rporecruitment.co.za or email your CV to: manufacturing@rpo-recruit.za.com

You can also apply for this role today by contacting Joshua Murphy at joshua.murphy@rporecruitment.us or on LinkedIn.

We will contact you telephonically within 3 days should you be suitable for this vacancy. If you are not suitable, we will keep your CV on file and contact you for future opportunities.