HOSPITAL CASE MANAGER PRIVATE HOSPITAL KZN

Updated: March 19, 2024 01:05 AM GMT

Resource Associates

Durban

Introduction

The Case Manager utilizing clinical knowledge and expertise, mitigates financial risk through comprehensive and accurate coding of hospital events, communication with funders on justification for hospitalization level of care and length of stay.

Duties & Responsibilities

RESPONSIBILITIES INCLUDE:
• Responsible for application of clinical knowledge in justifying patient hospitalization in terms of treatment, length of stay and level of care.
• Conducting Ward rounds on identified patients
• Monitor and action risk related to medical aid benefits and hospitalization
• Ensure accurate, specific and comprehensive clinical coding
• Timeous, effective communication and follow up with medical aids
• Review authorization aspects approved, mitigating financial risk and final releasing the case for billing
• Liaise with a network of internal and external stakeholders regarding patient treatment
• Adhere to the NHN Managed Health Care rules of engagement
• Compliance with all... More Detail