Dpsa Vacancies 2022 – CASE MANAGER

Website Dpsa

REQUIREMENTS : Minimum educational qualification: A health-related qualification (or equivalent)
registerable with the Health Professionals Council of South Africa (HPCSA) or
South African Nursing Council (SANC). Experience: Appropriate experience
in Hospital Case Management and or a Managed health organisation with a
revenue generation focus. Appropriate experience in ICD10 diagnostic and
procedural code assignment. Inherent requirement of the job: Valid (Code
B/EB) driver’s license. Competencies (knowledge/skills): Knowledge of using
Uniform patient fees structures. Computer literacy (MS Word and Excel)
including web-based Programmes (medical aids) Knowledge of Medical Aid
Act 131 of 1998 and application of Prescribed Minimum Benefits (PMB)
inclusive of Chronic disease list. Knowledge of RAF and other state
departments. Proficiency in at least two of the three official languages of the
Western Cape. Ability to analyse, prioritize, and solve problems, this includes
implementing an improvement process. Strong sense of responsibility with
good supervisory, interpersonal and communication skills. Knowledge of staff
performance, and disciplinary processes.
DUTIES : Responsible for the management and implementation of Case Management
policies, protocol and procedures in the hospital. Perform operational Case
Management functions inclusive of pre-authorisation and clinical review to
ensure compliance with Case Management policies and procedures. Conduct
clinical audits of patient accounts to ensure accuracy of invoices for submission
to medical aids and state departments. Provide support to the hospital Fees
Department in terms of follow-up of outstanding medical scheme and state
department balances and account queries. Assist with EDI rejections to ensure
timeous submission of medical scheme invoices. Provide quotations to H2, H3
and Foreign patients. Supervision of staff and liaison with relevant role players
in matters relating to Case management. Assist Hospital Management in the
distribution of Quality Client Care. Compile statistical reports.

To apply for this job please visit www.dpsa.gov.za.