Case Manager: Corporate Support | Mediclinic
Job Location : Western Cape, Stellenbosch
Deadline : January 19, 2026
About the Role
The Case Manager drives operational efficiency by managing high-RPM clinical data and ensuring 100% compliance with healthcare funding and insurance protocols. Utilizing SAP for financial record integration and specialized healthcare data platforms, the manager mitigates operational risk in patient billing and care coordination. Their role is critical for leveraging data to optimize hospital resource allocation and ensure the commercial sustainability of corporate healthcare services.
MAIN PURPOSE OF JOB
- To support the hospital in the absence of hospital Case Managers and to facilitate the communication process between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation; and to support efficient and effective hospital cash conversion
KEY RESPONSIBILITY AREAS
- Minimise financial risk by effectively managing patient stay
- Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems
- Ensure correct and timeous finalisation of cases, and consistently and timeously communicate with Funders to facilitate reimbursement of claims
REQUIRED EDUCATION
ESSENTIAL EDUCATION
- Nursing qualification
DESIRED EDUCATION
- Registered Nurse / Professional Nurse
REQUIRED EXPERIENCE
ESSENTIAL MINIMUM EXPERIENCE
- 3 – 5 years in a nursing role
DESIRED EXPERIENCE
- Experience in Theatre and/ or ICU
- Medical aid background
- Experience in the private healthcare environment
REQUIRED JOB SKILLS AND KNOWLEDGE
- Anatomy; physiology and terminology
- Application and validation of clinical codes (Level 3 coding)
- Authorisation and motivation of Level of Care; Length of Stay; Short Payments etc.
- B2B EMS (Electronic message system: check status of authorisations and use for trouble-shooting)
- Computer literacy (e.g. Outlook and intranet applications)
- Daily Workflow, Managing deviances, Coding, and Case Management processes
- Funder Contracts; Medical aid requirements/narrations
- Patient Administration policies and procedures (Patient Confidentiality, Visitation of external case managers, etc.)
- Proficient all relevant Patient Admin systems and programs
- Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB, etc.)
- Scientific Nursing Processes and associated procedures
Closing date: 12/01/2026
Career Growth & Education
A degree in Nursing or Allied Health Sciences is mandatory, with a post-graduate qualification in Case Management or Health Economics highly preferred. Professionals can advance to Hospital Manager or Director of Clinical Operations by mastering healthcare performance analytics. Participating in specialized bootcamps in digital health governance and obtaining professional certifications provides a pathway to senior roles in international healthcare organizations.
Salary & Financial Insight
Monthly salaries typically range from R35,000 to R58,000, reflecting the technical and regulatory nature of clinical administration. Focused financial planning should include building a robust retirement strategy and maintaining comprehensive income protection insurance.
Interested and Qualified candidates should Click here to Apply Now
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