Case Manager

Minimum educational qualification: A qualification at NQF level 7 or equivalent that allows registration with the Health Professions Council of South Africa (HPCSA) and/or South African Nursing Council (SANC) and/or South African Pharmacy Council (SAPC). Experience: 3 Year’s relevant experience. Competencies (knowledge/skills): Knowledge of the Medical Schemes Act 131 of 1998, regulations and annexures as amended and basic knowledge of the uniform patient fees schedule and patient billing.

Knowledge of prescribed minimum benefits i.e. the chronic disease list and diagnostic treatment pairs and knowledge of and experience in ICD 10 Codes assignment, the ability to link patient diagnosis with procedure codes and knowledge of Clinicom and EDI (Electronic Data Interchange). Ability to work with Excel spread sheets, Microsoft Word and web-based programs (medical aids). Good communication, conflict management, interpersonal and leadership skills.

Maintain efficient and effective communication with all role players to ensure full settlement of accounts. Evaluate and monitor ICD 10 coding for externally funded patients. Interpret and implement Case Management policies, protocols and procedures efficiently and effectively. Coordinate the workflow processes between clinical and admin personnel. Managerial/Supervisory functions.

Applications are submitted online via www.westerncape.gov.za/health-jobs (click “online applications”).

Ms M Frieslaar, email: [email protected]

No payment of any kind is required when applying for this post.