Website Busamed Hospital Group
Busamed Hospital Group is an award-winning, black-owned South African private hospital group founded in 2016. Led by CEO Dumani Kula and founder Dr. Diliza Mji, the group operates seven multidisciplinary hospitals across the country with a focus on "Premium Care with a Personal Touch"
The Case Manager will be responsible for the liaison between the patient and medical aids in order to secure payment for the hospital.
- Grade 12 or equivalent NQF level 4 qualification
- Diploma in Nursing Qualification is essential/ SANC registration is compulsory
- Previous Case Management in Acute Rehab experience is advantageous
- ICD & CPT Coding would be advantageous
- Intermediate computer skills
- Excellent interpersonal and communication skills
- Knowledge of Medical aids
- Ensuring all the relevant details on Hospital Billing System are updated and are accurate
- Supply all details regarding the patients’ history to Clinical partners
- Monitor and control costs for Managed Care Organization patients
- Confirm length of stay for all Managed Care Organization patients
- Accompany Managed Care Organization Case Managers on ward rounds in the hospital
- Assist with final authorization of Managed Care patient files
- Ensure correct coding for all Managed Care Organization patients
- Consult with the relevant services providers regarding the patient care treatment
- Assist with the transfer of patients to Rehab hospital or step down facilities
- Arrange in-service training for relevant staff to meet the needs of the theatre department
- Liaise network of internal and external stakeholders to ensure that managed care of patients is maintained
- Actively participate as a member of a team to achieve goals
- Active involvement in own professional development to maintain a satisfactory level of skill and knowledge
- Work effectively and co-operatively with others to establish and maintain good working relationships that are mutually beneficial
- Develop collaborative relationships to help accomplish work goals and targets
