Hospital Case Manager

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Mediclinic Constantiaberg| Plumstead, Cape Town | South Africa

Closing date: 22/01/2026
Number of positions: 1
Recruiter name:
Nontombi Ncediwe
Reference number: 66659
Workplace Type:

On-site
Permanent

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 coordinate the hospital case management process and facilitate the communication process between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation.

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 to facilitate reimbursements from funders of claims

Consistently and timeously communicate with Funders as contractually agreed through the relevant case management channels

Ensure clinical coding standards are adhered to as per Level 3 coding guideline

Lead and manage the people in the Case Management team (if applicable)

DESIRED

EDUCATION:

Registered Nurse / Professional Nurse or qualified Paramedic

ESSENTIAL

MINIMUM EXPERIENCE:

Minimum of 3 years in a clinical role

DESIRED

EXPERIENCE:

Experience in Theatre and or ICU;
Medical aid background;
Experience in private healthcare environment or experience as an ILS/ALS Paramedic

• Anatomy (including terminology)
• Funder Contracts;
  Medical aid requirements/narrations
• Patient admin programmes on the AS400 system
• Scientific nursing principles and process
• Authorisation and motivation of Level of Care;
  Length of Stay;
  Short Payments etc.
• Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.)
• Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.)
• Daily workflow; managing deviances; coding; and case management processes
• Application of clinical codes and finalisation thereof

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

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