Case Manager – Groote Schuur Hospital – Western Cape Department Of Health

About the Role

The Western Cape Department of Health is searching for a dedicated Case Manager to join their team at Groote Schuur Hospital in Observatory. In this vital role, you will be at the forefront of ensuring the well-being of patients by managing and overseeing case management functions within one of South Africa’s leading hospitals. Your work will directly impact the delivery of healthcare services, enhancing the quality of life for patients and their families in the community.

As a Case Manager, you will play a key role in conducting clinical audits, coordinating workflows, and implementing case management policies. The importance of this position cannot be overstated, as it not only contributes to the operational efficiency of the hospital but also ensures that patients receive the appropriate care and benefits they are entitled to. This is an opportunity to make a real difference in the healthcare sector and be part of a compassionate, community-focused environment.

About the Department

The Western Cape Department of Health is committed to providing accessible and quality healthcare services to the residents of the province. Its mission is to promote health, prevent disease, and ensure that all individuals receive the medical attention they need. Working here means being part of a team that prioritizes health equity and strives to improve the overall well-being of the community. This role is meaningful as it aligns with the department’s goal of enhancing healthcare delivery and ensuring patients receive the best possible outcomes.

What You’ll Do

• Conduct clinical audits for Medical Aids and State Departments to verify invoice accuracy.
• Coordinate workflow processes between clinical and administrative staff, facilitating various roles within the hospital.
• Implement Case Management policies, protocols, and procedures effectively.
• Oversee hospital Case Management functions related to authorizations and benefit management.
• Review clinical information for clients with external funding and provide accurate quotations for privately funded patients.
• Compile and present statistical reports for departmental use and analysis.
• Provide relief for colleagues as needed, ensuring continuous support for staff and patients.
• Supervise staff and liaise with relevant stakeholders concerning Case Management matters.

What You’ll Need

• A three-year health-related National Diploma or Degree that is registrable with the Health Professions Council of South Africa (HPCSA) or South African Nursing Council (SANC).
• Relevant experience in a Case Management or Medical Aid environment.
• Strong knowledge of ICD-10 codes and their applications in clinical settings.
• Familiarity with the Uniform Patient Fees Schedule and Hospital Information Systems.
• Understanding of the Medical Aid Act 131 of 1998 and Prescribed Minimum Benefit (PMB) legislation.
• Proficiency in MS Excel and web-based programs used in medical aid administration.
• Excellent verbal and written communication skills.

How to Apply

Applications can be submitted by hand delivery during office hours to 20 Steve Biko Street, Agriculture Place, Arcadia, Pretoria, 0002 or by email [email protected].