About the Role
The Department of Health is seeking passionate individuals for the position of Clinical Case Manager at both Piet Retief Hospital and Standerton Hospital, located in the Gert Sibande District of Mpumalanga. This vital role is designed for experienced nursing professionals who are ready to make a significant impact on the health services provided to the community. As a Clinical Case Manager, you will play a crucial role in managing patient care efficiently, ensuring that patients receive the necessary support and services during their hospital stay.
This position is essential not only for the hospitals involved but also for the wider community that relies on these facilities for quality healthcare. With the increasing complexity of patient needs and the evolving landscape of healthcare funding, the Clinical Case Manager will be pivotal in liaising with various stakeholders, including medical schemes and clinicians, to facilitate smooth operations and high-quality patient care. Your expertise will directly contribute to the betterment of health outcomes in the Piet Retief and Standerton areas, making this an exciting opportunity to serve the public in a meaningful way.
About the Department
The Department of Health is dedicated to providing accessible, quality healthcare to all South Africans. With a mission to promote health, prevent illness, and manage health services effectively, the department plays a crucial role in enhancing the well-being of communities across the nation. Working with the Department of Health means being part of a larger effort to ensure that every citizen has access to the care they need, thereby fostering a healthier society.
The department is committed to supporting its staff through professional development, collaboration, and a shared vision of health equity. By joining this team, you become part of a workforce that is focused on improving public health and making a difference in the lives of people within your community.
What You’ll Do
- Identify and select patients for case management intervention based on external funding sources.
- Conduct case management tasks including obtaining pre-authorisation for emergency admissions and verifying benefits with medical schemes.
- Perform daily ward rounds to identify billable services and ensure compliance with funding criteria.
- Collaborate with clinicians and medical scheme case managers to monitor patient utilisation and care quality.
- Monitor ICD-10 coding accuracy and other clinical information to prevent claim rejections.
- Assist the revenue office with accurate ICD-10 coding and provide appropriate procedure codes.
- Compile monthly clinical statistics on managed cases, including ICD-10 codes and authorisations obtained.
What You’ll Need
- Senior Certificate / Grade 12 qualification.
- Basic qualification accredited with the SANC, such as a Diploma or Degree in General Nursing, allowing registration as a Professional Nurse and Midwifery.
- A post-basic nursing qualification (at least 1 year) accredited with the SANC in ICU/Critical Care Science is advantageous.
- Minimum of four years of professional nursing experience after registration with SANC.
- Strong leadership, interpersonal, problem-solving, and decision-making skills.
- Knowledge of the Uniform Patient Fees Schedule (UPFS) and the Medical Schemes Act 131 of 1998.
- Experience with ICD-10 Code assignment and linking patient diagnosis with procedure codes is an advantage.
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].
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