Case Manager | General Wards South Africa

Life Healthcare is actively recruiting for a Case Manager | General Wards position in South Africa. This is an excellent opportunity for professionals in the Medical / Healthcare sector looking to advance their careers.

• Experience Level: 3 years • Educational Background: Others or equivalent • Industry Focus: Medical / Healthcare • Location Preference: in South Africa

Healthcare professionals including Case Manager | General Wards are essential service providers. This role contributes directly to community health and wellbeing.

This role in Medical / Healthcare offers valuable career progression opportunities aligned with your experience level and professional aspirations.

When applying for this Case Manager | General Wards position, ensure your CV highlights: • Relevant experience matching the 3 years requirement • Educational qualifications in line with Others • Specific achievements in the Medical / Healthcare field • Any certifications or specialized training

The Medical / Healthcare sector in South Africa continues to show strong demand for skilled professionals. This position represents a valuable opportunity in the current job market.

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A vacancy exists for a Case Manager General Wards based at Life Hilton Private Hospital, reporting to the Patient Services Manager, Sharona Singh. The successful candidate will be responsible for managing the financial and clinical risks of the patient in a general ward by ensuring accurate coding, clinical updates and accounts submissions of patient hospitalization to achieve strategic objectives.

Critical Outputs

Ensuring the maximisation of revenue by

Ensuring accuracy of coding Ensuring the correct application and interpretation of RSRT’s Participating in meetings and reporting losses to RSRT team and recommend corrective actions Monitoring insurance verification and workflow processes

Ensuring effective management of quality outputs by

Performing quality walkabouts and implement corrective measures Implementing and monitoring quality improvement programmes Adhering to patient services escalation processes in order to achieve QMS targets Monitoring Q-evaluator scores and implementing corrective measures Investigating internal and external stakeholder complaints Ensuring the adherence to customer service standards

Ensuring operational excellence by

Monitoring submission of accurate accounts to funders Updating length of stay and level of care to funders of general ward cases and where operationally required specialised unit cases. Releasing care risk targets and submission within two days of discharge Ensuring the compliance to LHC policies and managing authorisations and claim submissions, rejections and delays Ensuring governance and risk management by monitoring and adhering to patient services policies and procedures Ensuring compliance to service level agreements with internal and external stakeholders Ensuring all billing checks are closed by the relevant function areas

Ensuring effective management of relationships with internal/external stakeholders by

Building and maintaining relationships with internal stakeholders Providing feedback and information on concerns or issues raised by internal stakeholders Providing and facilitating training regarding RSRT contracts to the relevant internal stakeholders Ensuring effective communication with external stakeholders Managing escalated concerns from Case Managers with external stakeholders Escalating doctor non-compliance in terms of RSRT framework to RSRT meetings

Diploma or degree in Nursing, Physiotherapy, Clinical Associates, Paramedics as Critical Care Assistants or Emergency Care Practitioners or any other qualification that covers Anatomy, Physiology, Pathophysiology and Microbiology as foundational courses. Current SANC registration Atleast 3 years experience as a Case Manager in a Hospital Environment Knowledge of hospital patient services and case management processes Knowledge and understanding of CPT & ICD coding Knowledge of Funder contracts, scheme rules, exclusions and benefits Understanding of private hospital industry and practices Computer proficiency

Competencies

Attention to detail Problem-solving, analysis and judgement Resilience Engaging diversity Verbal & written communication skills Professional and technical proficiency Building relationships Customer responsiveness Organisational awareness Influencing skills Action orientation Excellence orientation Ethical behaviour

Deadline:19th August,2026