Case Manager

SUMMARY:
Case Manager - Rehabilitation Centre

POSITION INFO:

Case Manager – Physical Rehabilitation Hospital

Location: Durban, KwaZulu-Natal

Our client, a leading non-profit medical scheme, is seeking a dynamic and experienced Case Manager to join their physical rehabilitation hospital team. This role is ideal for a compassionate healthcare professional with strong clinical coding skills and a passion for patient advocacy and cost-effective managed care.

Key Responsibilities

• Conduct clinical assessments of patients referred for admission, including on-site visits to hospitals.

• Build and maintain professional relationships with referring doctors, hospitals, and medical aid stakeholders.

• Manage and oversee all billing processes, ensuring accuracy and compliance with medical aid requirements.

• Submit and motivate for pre-authorisations and ex gratia benefits with medical schemes.

• Collaborate with therapists, doctors, and the nurse manager to develop and monitor care plans.

• Provide effective risk management to reduce hospitalisation costs while ensuring quality patient care.

• Deliver cost-effective managed healthcare services to maximise member satisfaction.

• Stay updated through ongoing training and development to maintain CPD compliance and clinical coding standards.

Requirements

• Registered Nurse (SANC) or Physiotherapist with valid professional registration.

• Qualification or solid working knowledge in ICD-10 and CPT coding.

• Minimum 5 years’ clinical experience, preferably in Trauma, ICU, or Theatre.

• Strong ability to build and maintain relationships with doctors and healthcare professionals.

• Proficiency in MS Office Suite and hospital billing systems.

• Excellent English and Afrikaans communication skills (verbal and written).

• Valid driver’s license and own transport (travel to hospitals required).

Behavioural Competencies

• Strong organisational skills and attention to detail with the ability to prioritise effectively.

• Excellent problem-solving techniques and a caring, patient-focused attitude.

• Leadership skills with the ability to take responsibility and work collaboratively in a multidisciplinary team.

• Flexibility to adapt to change and support management decisions to achieve common goals.

Salary

Market-related, commensurate with experience.