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Integrated Care Case Manager

Medihelp
R 274 031 - R 346 984 a year
Pretoria, Gauteng
Full time
4 days ago

At Medihelp, we live our values daily excellence, compassion, collaboration, and transparency to make a real difference in the lives of our members. Were looking for someone who lives these values through their mindset, work ethic, and interactions with others.

The core purpose of the role is to identify the financial risks and impact of hospitalized members on the scheme. This is achieved by recommending funding for medical treatment at the most appropriate facility to minimize financial risk. The role also involves coordinating services between the member and the service provider to ensure proper treatment benefit allocation, aiming to prevent complications and readmissions cost-effectively.

Requirements

Grade 12, with a completed degree/diploma as a registered nurse and currently registered with the SANC.

Four years of relevant experience in Managed Healthcare or experience as a registered nurse in a hospital environment,

Key Competencies

Good verbal and written communication skills

Computer literate

Customer focus

Good negotiation and decision-making skills

Comprehensive knowledge of the Medical Scheme Act

Willing to be multi-skilled in other sections within managed care

Join a team where our values guide everything we do from how we work together to how we serve our members.

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