Hospital Case Manager | Mediclinic
Job Location : Western Cape, Cape Town
Deadline : January 19, 2026
About the Role
The Hospital Case Manager drives high-RPM clinical efficiency by managing patient clinical data and ensuring 100% compliance with medical scheme protocols and national health standards. Utilizing SAP for financial orchestration and specialized health informatics, the manager mitigates operational risk in healthcare funding. Their expertise leverages data-driven insights to optimize patient lengths of stay and ensures the technical reliability of clinical outcomes in a private hospital.
MAIN PURPOSE OF JOB
- To coordinate the hospital case management process and facilitate the communication process between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation.
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 to facilitate reimbursements from funders of claims
- Consistently and timeously communicate with Funders as contractually agreed through the relevant case management channels
- Ensure clinical coding standards are adhered to as per Level 3 coding guideline
- Lead and manage the people in the Case Management team (if applicable)
REQUIRED EDUCATION
- ESSENTIAL EDUCATION: Clinical qualification
- DESIRED EDUCATION: Registered Nurse / Professional Nurse or qualified Paramedic
REQUIRED EXPERIENCE
- ESSENTIAL MINIMUM EXPERIENCE: Minimum of 3 years in a clinical role
- DESIRED EXPERIENCE: Experience in Theatre and or ICU; Medical aid background; Experience in private healthcare environment or experience as an ILS/ALS Paramedic
REQUIRED JOB SKILLS AND KNOWLEDGE
- Understanding of anatomy; physiology and medical terminology
- Funder Contracts; Medical aid requirements/narrations
- Scientific nursing principles and process
- Authorisation and motivation of Level of Care; Length of Stay; Clinical Coding, high-cost stock, Short Payments etc.
- Use of electronic systems (i.e. B2B or Funder portals) for the purposes of requesting authorisations, performing case management updates and for troubleshooting)
- Computer literacy (Microsoft Office, hospital/practice management systems)
- Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.)
- Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.)
- Daily workflow; managing deviances; clinical coding; and case management processes
- Application of clinical codes and finalisation thereof
Closing date: 19/01/2026
Career Growth & Education
A degree in Nursing or a relevant Health Science is mandatory, alongside active HPCSA or SANC registration. Career progression leads toward Hospital Manager or Clinical Operations Director roles within the private healthcare sector. Pursuing specialized bootcamps in health informatics and obtaining advanced certifications in healthcare management provides a pathway to senior leadership in global health groups.
Salary & Financial Insight
Estimated monthly salaries range from R35,000 to R58,000, reflecting the high technical and clinical responsibility. Healthcare professionals should focus on professional wealth management and early enrollment in a diversified retirement annuity to secure their future.
Interested and Qualified candidates should Click here to Apply Now
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