Job Advert Summary

We are seeking an experienced and highly motivated Clinical Case Manager to join our Managed Healthcare team. The successful candidate will be responsible for managing hospital authorisations, oncology and high-cost cases, utilisation management, PMB assessments, and clinical case management activities in accordance with scheme rules, clinical protocols, and regulatory requirements.

Minimum Requirements

Education

• Grade 12
• Registered nursing qualification essential.
• Intensive Nursing Science desirable.

Experience

• Computer literacy (MS Office and Medical Administration system) desirable.
• Operating Theatre or ICU experience desirable.
• Previous exposure in Renal Dialysis, Oncology and/or Psychiatric environment desirable.
• Sound knowledge of the Coding Systems: ICD10 & CPT4 Principles desirable.
• Effective conflict resolution skills and the ability...