DEPARTMENT OF HEALTH
Case Manager (2 posts)
DIRECTORATE: MANAGEMENT ACCOUNTING (HEAD OFFICE, CAPE TOWN)
REMUNERATION: R281 418 PER ANNUM
SERVICE BENEFITS: 13TH CHEQUE, EMPLOYER’S CONTRIBUTION TO THE PENSION FUND, HOUSING AND MEDICAL AID ALLOWANCE
Requirements: Minimum educational qualification: A health related qualification registrable with the Health Professions Council of South Africa (HPCSA) or South African Nursing Council (SANC). Experience: Appropriate experience in Case Management/Medical Aid Environment and Revenue Generation. Inherent requirements of the job: Willingness to travel and spend long periods away from the office • Valid (Code B/EB) drivers licence. 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 spread sheets, Microsoft Word and web based programs (medical aids).
Duties (key result areas/outputs): Assist various institutions with clearing of externally funded revenue back logs related to ICD-10 code assignment, UPFS assignment and the management of PMB conditions • Assist various Hospital Fees Departments with follow-up of outstanding medical scheme and state department balances and account queries • Conduct clinical audits of patient accounts to ensure accuracy of invoices for submission to medical aids and state departments • Perform operational Case Management functions at various institutions inclusive of pre-authorisation and clinical review to ensure compliance with Case Management policies and procedures • Assist with EDI rejections to ensure timeous submission of medical scheme invoices • Provide quotations to H2, H3 and Foreign patients • Assist with the implementation of departmental case management policies and procedures by providing onsite skills development and training of relevant role players in matters relating to Case management.
Note: No payment of any kind will be required when applying for this post. This post will not be linked to any of the Occupational Specific Dispensations. Candidates who applied previously need not to apply again.
Enquiries: Ms L Ismail, tel. 072 601 6586
Closing Date: 1 September 2017
PLEASE SUBMIT YOUR APPLICATION FOR THE ATTENTION OF MS C DAWOOD, TO THE DIRECTOR: PEOPLE PRACTICES AND ADMINISTRATION, DEPARTMENT OF HEALTH, PO BOX 2060, CAPE TOWN 8000.
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 aforementioned will not be considered. Applications must be forwarded to the address as indicated on the advertisement. No late, faxed or e-mailed applications will be accepted. CVs 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 short-listed 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 short-listed 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.