Case Manager

Western Cape Gevernment

Western Cape Government logo

 

Component Department of Health

Institution: Red Cross War Memorial Children’s Hospital, Rondebosch

Core Title: Economic Advisory and Support Personnel

Service benefits:

13th Cheque, employer’s contribution to the pension fund, housing and medical aid allowance.

Requirements, minimum educational qualification:

A health-related qualification is registrable with the Health Professions Council of South Africa (HPCSA) or the South African Nursing Council (SANC).

Experience:

Appropriate experience in Case Management/Medical Aid environment and Revenue Generation.

The inherent requirement of the job:

Willingness to work overtime.

Competencies (knowledge/skills):

Good knowledge of the Uniform Patient Fees Schedule(UPFS), Managed Health Care or Hospital Information Systems and EDI (Electronic Data Interchange). Knowledge of the Medical Schemes Act 131 of 1998 and the application of Prescribed Minimum Benefit(PMB) legislation i.e. the Chronic Disease List(CDL) and Diagnostic Treatment Pairs(DTP). Experience in ICD-10 Code assignment and the ability to link patient diagnosis with procedural codes. Ability to work with Excel spreadsheets, Microsoft Word and web-based programs (medical aids). Excellent communication, conflict management, interpersonal and leadership skills. Excellent written and verbal communication in at least two of the three official languages of the Western Cape. Must be conversant in at least two of the three official languages of the Western Cape.

Duties (key result areas/outputs):

Perform Case Management functions, i.e. assist with authorisation, concurrent, retrospective review, discharge planning and liaison with various role players and third parties to monitor utilisation. Provide quotations to H2, H3 and Foreign patients. Assist with the assignment of ICD-10 codes when required and identification of PMB conditions. Manage and implement Case Management policies, protocols and procedures in the hospital, (including providing the necessary on-site skills development and training of all relevant role players). Conduct clinical audits of patient accounts inclusive of medical aids, State Departments, e.g. RAF and COIDA to ensure the accuracy of invoices w.r.t ICD 10 codes, UPFS procedure codes and resource utilisation. Provide support in terms of hospital account queries and assist with follow up of outstanding medical scheme balances (Medikredit EDI reports). Supervision of staff and liaison with relevant role players in matters relating to Case management.

Note:

This post does not form part of any Occupation Specific Dispensation. No payment of any kind is required when applying for this post. Shortlisted candidates may be required to complete a practical test.

INSTRUCTIONS TO APPLICANTS:

Z83 forms (obtainable from any Government department or www.westerncape.gov.za) must: Be completed in full, clearly reflect the name of the position, name and date of the publication (candidates may use this as reference), be signed, accompanied by a comprehensive CV, the names of 3 referees and certified copies of ID, driver’s licence and qualification/s. A separate application form must be completed for each post. Applications without the afore-mentioned will not be considered. Applications must be forwarded to the address as indicated in the advertisement. No late, faxed or e-mailed applications will be accepted. CV’s will not be returned. Excess personnel will receive preference. Applications, which are received after the closing date, will not be considered. Further communication will be limited to shortlisted candidates. If you have not received a response from the Department within 3 months of the closing date, please consider your application as unsuccessful. It will be expected of candidates to be available for selection interviews on a date, time and place as determined by the Department.

As directed by the Department of Public Service & Administration, applicants must note that further checks will be conducted once they are shortlisted and that their appointment is subject to positive outcomes on these checks, which include security clearance, qualification verification, criminal records, credit records and previous employment.

The Department of Health is guided by the principles of Employment Equity. Candidates with a disability are encouraged to apply and an indication in this regard will be appreciated.

Salary R 299 709 per annum
Salary Level Level 8

Applications To:

The Chief Executive Officer: Red Cross War Memorial Children’s Hospital
Private Bag X5
Rondebosch
7700

(For attention: Mr P Petersen)

Closing Date 22 March 2019

Enquiries
Ms HJ van Graan
Tel: (021) 658-5007

2019-03-08T16:55:15+02:00