Reference: PE000208-HP -1 Prominent Healthcare and Risk Management company has a permanent vacancy for a Register Professional Nurse with Case Management experience and a private hospital nursing background. The role is 100% office-based and located in Port Elizabeth, EC. QUALIFICATIONS AND EXPERIENCE: Matric essential. It is essential to have a Nursing Diploma or Degree. Minimum of 2 years clinical experience within a private hospital is essential The incumbent must be registered with the South African Nursing Council as a Registered Nurse (Auxillary/ Enrolled Nurses do not qualify for application). A certificate in ICD-10 coding is highly advantageous Experience in a managed care / case management environment would be an advantage. MS Office / Office 365 proficiency. Open to SA citizens with a clear criminal and credit history. Valid unendorsed Driver's License is essential, with own vehicle (preferred). Must be well presented and have stature as he/she will be dealing with Clients and Doctors. ROLES AND RESPONSIBILITIES: Reporting to the Team Manager performance areas include, but are not limited to: Review of in-hospital patients for appropriateness of care, length of stay and level of care. Liaise with the service provider on clinical updates, as well as outstanding information. Engage with the treating doctor(s) to ensure appropriate treatment, length of stay and level of care is rendered. Discharge planning for in-hospital patients to ensure ongoing support and care post discharge. Develop, implement and communicate the practice and/or clinical guidelines for cost effective care. Authorise appropriate and cost-effective surgical care and treatment. Ensure the consistent and correct application of exclusions. Adhere to policies and procedures and take corrective action where necessary. Adhere to organisational best practice and legislative requirements. Take ownership of escalated and unresolved queries and ensure they are resolved timeously. Manage queries until resolution and update the incident details. Identify financial and business risks to the company and escalate accordingly. Provide clinical support to non-clinical team's if/when required. Drive and support effective teamwork within the department. Strive to demonstrate the company's values daily. Engage in hospital visits where needed to build stakeholder relationships, proactively resolve queries and increase visibility to members. Ensure the effective, accurate and timeous completion of relevant documentation and recording of interventions. Communicate with providers to improve the cost efficiencies of health care delivery. Ensure Service Level Agreements are met and exceeded. Continuously develop own expertise in terms of industry and subject matter development and application thereof in an area of specialisation. IMPORTANT ATTRIBUTES Must possess an ownership mentality and a willingness to take responsibility for tasks through to completion. Attention to detail, goal orientated and a desire to achieve your objectives. Highly organised, good at multi-tasking and able to deal with people at all levels. Effective communication skills, verbal and written Accountability. Planning and organising. Problem solving. Time management. Attention to detail. Interpersonal skills. Customer orientation. Results driven. Empathetic nature. Business Administration skills. Location: Port Elizabeth Profile: Healthcare Career Level: 2 years in a Private Sector Nursing Employment: Permanent, full-time E.E. / Non-EE: Strictly EE - African, Coloured and Indian Working Hours: Monday to Friday, 08H00 - 17H00 Remuneration: Market related basic Compulsory Medical Aid and Provident Fund. Short listed candidates may be expected to complete and pass assessments before moving to the next stage of the recruitment process. Should you not be contacted within two weeks, please consider your application unsuccessful. Registered Professional Nurse: Case Manager plus Compulsory Medical Aid and Provident Fund Apply Now

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Professional Nurse: Case Manager - South Africa

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