About this role
<p><strong>Mediclinic Hoogland | Bethlehem | South Africa </strong></p> <p><br>Closing date: 06/07/2026 <br>Number of positions: 1 <br>Recruiter name: Tebello Sekhoto <br>Reference number: 71413 <br><span id="cke_bm_1564S" style="display:none"> </span>Workplace Type: On-site<br>Permanent</p> <p><em><strong><span style="font-size:10.0pt">Please note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profile</span></strong></em></p><div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px"><b>MAIN PURPOSE OF JOB</b></H2> </div><div><p><span style="font-size:10.0pt"><span style="font-family:'Arial', sans-serif"><span style="color:#555146">To coordinate the hospital case management process and facilitate the communication process between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation.</span></span></span></p> <p><span style="font-size:10.0pt"><span style="font-family:'Arial', sans-serif"><span style="color:#555146">Please note: the suitable incumbant will have proven case/financial experience within a private healthare facility. This is a non-clinical Case Manager role.</span></span></span></p></div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px"><b>REQUIRED EDUCATION</b></H2> </div><div><p style="margin-bottom:13.0px"><strong><span style="font-size:10.0pt"><span style="font-family:'Arial Black', 'sans-serif'"><span style="color:#555146">ESSENTIAL EDUCATION</span></span></span></strong><span style="font-size:10.0pt;font-family:arial, helvetica, sans-serif"><span style="color:#555146">: Matric with a relevant tertiary qualificaiton </span></span></p> <p style="margin-bottom:13.0px"> </p></div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px"><b>REQUIRED EXPERIENCE</b></H2> </div><div><p style="margin-bottom:13.0px"><strong><span style="font-size:10.0pt"><span style="font-family:'Arial Black', 'sans-serif'"><span style="color:#555146">ESSENTIAL MINIMUM EXPERIENCE: </span></span></span></strong><span style="font-size:11.0pt"><span style="font-family:Calibri, sans-serif"><span style="font-size:10.0pt"><span style="font-family:'Arial', 'sans-serif'"><span style="color:#555146">Minimum of 3 years in a healthcare environment as a Case Manager </span></span></span></span></span></p> <p style="margin-bottom:13.0px"><strong><span style="font-size:10.0pt"><span style="font-family:'Arial Black', 'sans-serif'"><span style="color:#555146">DESIRED EXPERIENCE: </span></span></span></strong><span style="font-size:10.0pt;background-color:white"><span style="font-family:'Arial Black', 'sans-serif'"><span style="color:#555146"><span style="font-family:arial, helvetica, sans-serif">Proven experience as a Case Manager / Clinical Coder in Private Healthcare Environment </span></span></span></span></p></div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px"><b>KEY RESPONSIBILITY AREAS</b></H2> </div><div><p><span style="font-size:10.0pt"><span style="font-family:'Arial', sans-serif"><span style="color:#555146">Minimise financial risk by effectively managing patient stay</span></span></span></p> <p><span style="font-size:10.0pt"><span style="font-family:'Arial', sans-serif"><span style="color:#555146">Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems</span></span></span></p> <p><span style="font-size:10.0pt"><span style="font-family:'Arial', sans-serif"><span style="color:#555146">Ensure correct and timeous finalisation of cases to facilitate reimbursements from funders of claims</span></span></span></p> <p><span style="font-size:10.0pt"><span style="font-family:'Arial', sans-serif"><span style="color:#555146">Consistently and timeously communicate with Funders as contractually agreed through the relevant case management channels</span></span></span></p> <p><span style="font-size:10.0pt"><span style="font-family:'Arial', sans-serif"><span style="color:#555146">Ensure clinical coding standards are adhered to as per Level 3 coding guideline</span></span></span></p> <p><span style="font-size:10.0pt"><span style="font-family:'Arial', sans-serif"><span style="color:#555146">Lead and manage the people in the Case Management team (if applicable)</span></span></span></p> </div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px"><b>REQUIRED JOB SKILLS AND KNOWLEDGE</b></H2> </div><ul style="margin-top:0.0;margin-bottom:0.0"><li>Understanding of anatomy; physiology and medical terminology </li><li>Funder Contracts; Medical aid requirements/narrations </li><li>Scientific nursing principles and process </li><li>Authorisation and motivation of Level of Care; Length of Stay; Clinical Coding, high-cost stock, Short Payments etc. </li><li>Use of electronic systems (i.e. B2B or Funder portals) for the purposes of requesting authorisations, performing case management updates and for troubleshooting) </li><li>Computer literacy (Microsoft Office, hospital/practice management systems) </li><li>Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.) </li><li>Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.) </li><li>Daily workflow; managing deviances; clinical coding; and case management processes </li><li>Application of clinical codes and finalisation thereof </li></ul></div></div><p>All applicants will be considered, with the understanding that preference will be given in accordance with the Employment Equity Plan of Mediclinic Southern Africa, as well as internal applicants/employees that meet the minimum requirements.</p> <p><em><strong><span style="font-size:10.0pt">Please note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profile</span></strong></em></p> <p> </p>