Case Manager

Updated: March 08, 2024 08:55 AM GMT

Full-time Job in Swakopmund, Erongo Region

Momentum Metropolitan Holdings Limited

Swakopmund, Namibia

Role Purpose

The Case Manager will be responsible for hospital pre-authorization, clinical auditing of claims and all case management related functions. Reporting to the Manager of the Managed Health Care Department.

Requirements
• Grade 12 with 25 IGCSE points
• Degree or Diploma in Nursing Sciences
• Valid registration with the Health Professional Council of Namibia (HPCNA)
• 3 year’s Clinical working experience (private ward, casualty, ICU & theatre)
• Case management background and experience in the medical aid industry will be an added advantage.
• Valid Driver’s License

Duties and Responsibilities
• Hospital pre-authorization to ensure that procedures are medically acceptable according to the fund rules, regulations, and guidelines.
• Pre-authorisation of other services and benefits as per laid down procedures.
• Hospital Case management and major disease/illness management
• Auditing of private hospital claims and other claims as per the laid down procedure.
• Liaising... More Detail