IOD Case Manager

Gauteng, Full Time

This position is aimed at a dynamic and performance driven individual who can deliver administrative and clinical outputs whilst working effectively with people.

The successful candidate will apply their clinical knowledge in the risk management of patients in terms of length of stay, level of care and other benefits in terms of the Compensation for Occupational Injuries and Diseases (COID) Act and other relevant guidelines. Furthermore, they will monitor serious cases of hospital admissions and clinical escalated queries as well as provide pre-authorisation of procedures not covered by the COID Act.
The minimum requirements of the position are a Relevant B-degree / diploma with active nursing registration with SANC.
The candidate must have at least 3 years’ experience post qualification experience in ICU or theatre techniques, with at least 2 years’ experience in case management.
Good functional computer literacy, good literacy and numeracy skills, an excellent performance track record as well as extensive knowledge of hospital billing rules, industry tariffs (including ICD10 Codes, UPFS, CPT4 Coding, SEP, NAP and PMB’s) are further requirements of the job. Coupled with the above, a valid driver’s license is part of our minimum requirements.
Experience in a private hospital managed healthcare environment and knowledge of the COID Act and workman’s compensation will be a distinct advantage.
Excellent customer focus, the ability to work in a highly pressurized environment, quality orientation, reliability and excellent communication complete our requirements.

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