Medical Case Manager at Rand Mutual Assurance

Updated: April 20, 2024 02:48 PM GMT

Broadway.com

Emalahleni

THE JOB AT A GLANCE

As the Pensions Medical Case Auditor (PMCA), you will be responsible for effectively and efficiently rendering medical support to internal and external stakeholders.

WHAT WILL YOU DO?
• Monitoring of Hospital Admissions weekly and liaison with Case Managers.
• Give feedback to Case Managers and other Colleagues of Pensioners admitted in Hospitals and include for hospital utilisation management.
• Authorization of Pensioners Hospital admissions, Chronic Medications and Sundries, prosthetic repairs and replacement
• Adjudicate requests for subsequent care and refer to RMA doctor as necessary.
• Assess and adjudicate medical service provider reports and advise on invoices submitted and captured when requested.
• Visit medical service providers and hospitals to address Pensioners related issues
• Organize and attend scheduled clinics.
• Organize transport for SCI acute admissions, uro reviews and taxi fares for prosthetic pensioners.
• Visit existing high risk/cost... More Detail