CRITICAL OUTPUTS

• Participate in recruiting referring Doctors and other members of the professional team.
• Participate in recruiting referring Doctors, other members of the professional team and active marketing of the facility.
• Build productive relationships with healthcare professionals to ensure adequate referral rates to achieve budgeted occupancy levels.
• Conduct clinical assessments to ensure that transfers and admissions adhere to criteria.
• Obtain authorisation from funders/medical aids & submit required documentation during the patient stay to ensure timeous payment of accounts.
• Minimise the financial risk by effectively managing patients stay.
• Coordinate feedback from the multi-disciplinary team and communication on multiple platforms.
• Provide management, audit, progress and discharge reports.
• Effectively manage and maintain patient outcomes data.
• Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems.

REQUIREMENTS

• Registered with SANC as a Registered Nurse
• At least 3 years’ Case Management experience in a Sub-Acute or Acute hospital environment
• Previous experience in marketing services in a healthcare environment
• Working knowledge of ICD & CPT coding would be advantageous
• Working knowledge of Fund’s rules, limits & contracts; perdiem/fixed fee interpretation; tariffs an advantage
• Manage daily workflow, case management and coding processes
• Full computer literacy on all MS Office packages
• B2B EMS (electronic messaging systems: check status of authorisation and used for problem solving.
• Ability to build relationships with Health Care Professionals
• Excellent Administrative & Negotiation skills required
• Patient admin programmes on the AS400 system