Website Mediclinic
Mediclinic Group is a leading international private healthcare services group founded in 1983 in Stellenbosch, South Africa.
ABOUT MEDICLINIC
Mediclinic Group is a leading international private healthcare services group founded in 1983 in Stellenbosch, South Africa. It provides specialist-orientated, multi-disciplinary services across a broad spectrum of care in several global markets.
MAIN PURPOSE OF JOB
To support the hospital in the absence of hospital Case Managers and to facilitate the communication process between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation; and to support efficient and effective hospital cash conversion
KEY RESPONSIBILITY AREAS
- Minimise financial risk by effectively managing patient stay
- Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems
- Ensure correct and timeous finalisation of cases, and consistently and timeously communicate with Funders to facilitate reimbursement of claims
REQUIRED EDUCATION
ESSENTIAL EDUCATION
- Nursing qualification
DESIRED EDUCATION
- Registered Nurse / Professional Nurse
REQUIRED EXPERIENCE
ESSENTIAL MINIMUM EXPERIENCE
- 3 – 5 years in a nursing role
DESIRED EXPERIENCE
- Experience in Theatre and/ or ICU
- Medical aid background
- Experience in the private healthcare environment
REQUIRED JOB SKILLS AND KNOWLEDGE
- Anatomy; physiology and terminology
- Application and validation of clinical codes (Level 3 coding)
- Authorisation and motivation of Level of Care; Length of Stay; Short Payments etc.
- B2B EMS (Electronic message system: check status of authorisations and use for trouble-shooting)
- Computer literacy (e.g. Outlook and intranet applications)
- Daily Workflow, Managing deviances, Coding, and Case Management processes
- Funder Contracts; Medical aid requirements/narrations
- Patient Administration policies and procedures (Patient Confidentiality, Visitation of external case managers, etc.)
- Proficient all relevant Patient Admin systems and programs
- Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB, etc.)
- Scientific Nursing Processes and associated procedures
All applicants will be considered, with the understanding that preference will be given in accordance with the Employment Equity Plan of Mediclinic Southern Africa, as well as internal applicants/employees that meet the minimum requirements.
Please note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profile
To apply for this job please visit careers.mediclinic.com.
