Middlesex College
Job Title: Back Office Case Manager (High Cost)
Company: Middlesex College
Location: Bryanston, Sandton, Gauteng, South Africa
Posted: 2 weeks ago
Employment Type: Full-time
Seniority Level: Mid-Senior level
Job Function: Other
Industry: Higher Education
Job Description:
Middlesex College is looking for an experienced Back Office Case Manager for a high-cost case management position. This role is focused on basic medical and surgical case management of patients from admission through discharge to ensure clinically appropriate care and effective risk management. The position involves regular communication with hospitals, medical advisors, doctors, members, and their families.
Key Responsibilities:
- Case Management:
- Manage patient admissions to the hospital as per scheme protocols and guidelines.
- Monitor ongoing hospital cases and provide final updates, including negotiating for discounts.
- Communication and Updates:
- Handle telephonic and email case management.
- Communicate updates with medical advisors and ensure regular hospital updates.
- Handle email member queries regarding hospitalization and benefits.
- Manage written communication and motivation reports.
- Cost Containment and Negotiation:
- Ensure cost containment of hospital admissions and incidents.
- Negotiate internal prosthesis discounts and report the savings.
- Liaison and Coordination:
- Liaise with hospitals, doctors, members, and their families to ensure proper case management.
- Collaborate with other healthcare personnel within the organization.
- Provide clinical expertise where required.
- Miscellaneous Responsibilities:
- Ensure adherence to service level agreements (SLAs) for email responses.
- Follow up on member referrals to support programs.
- Perform ad hoc duties as required.
Essential Requirements:
- Qualifications:
- Must be a Registered Nurse.
- 3 to 5 years of experience in Back Office or Case Management.
- Desired Skills:
- Experience in high-cost case management.
- Strong communication and organizational skills.
- Ability to handle complex medical cases and coordinate effectively with different stakeholders.
How to Apply:
Interested candidates should send their CV and supporting documents to the provided email address. If you have not received feedback within 2 weeks, please assume your application was not successful.
This is a fantastic opportunity for a skilled Case Manager with a nursing background to contribute to patient care and cost management in a reputable organization.