2 weeks ago
Job title : Senior Officer: Field Case Management
Job Location : Western Cape, Cape Town
Deadline : October 03, 2024
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Key Performance Areas
Decision making regarding quality of care.
- Assessment of ongoing medical problems of the injured after discharge in the home environment.
- Assessment of patient according to prescribed measurements.
- Assessment of burden of care and needs of the client.
- Monitors of quality of care issues
- Selection and monitoring clinical pathways.
Decision Making regarding collaboration.
- Facilitates collaboration of service providers with client.
- Protector of privacy and confidentiality.
- Coordination of plan of care and services.
- Facilitate caregiver’s appointments necessary for the client.
- Facilitate timely consultation with appropriate medical service providers.
- Facilitate family and clinical team communication.
- Health educator and counsellor for client and family.
- Utilization review.
- Post discharge follow-through.
Decision making regarding advocacy criteria.
- Conflict resolution expert and referee.
- Liaison between patient and care team.
- Negotiating and procuring resources and services from providers.
- Benefit analysis.
- Record keeping and documentation.
- Maintain patient confidentiality.
Decision making regarding resource utilization.
- Post discharge follow-through.
- Drug utilization review.
- Assistive devices necessary for client.
- Home alterations.
- Vehicle adaptations.
- Vocational guidance after life changing event for client.
- Placement of children in special schools.
- Back to work opportunities.
Decision making regarding legal & ethical criteria.
- Advise client of accident relatedness of his claim.
- Decide reasonableness and appropriateness of service.
- Advise whether altering homes and placing clients in rehab centres or institutions is appropriate.
- Advice regarding payment of care givers taking into account patient autonomy, informed choice, medical implications and burden of care.
Pre-authorisation of admissions.
- Arrange for hospital admission and advise patients on their benefit.
Assess medical Bills.
- Assessment of bills received and advise claimants of outcomes of bill review.
Recommend payment.
- Recommend payment of bills assessed.
Qualifications
- Bachelor’s degree or Advanced Diploma in Nursing/ Allied Health Professions or related qualification.
- Registration with the relevant Health professions council.
- Knowledge of ICD and CPT coding will be an advantage.
- Valid code 8 driving license.
Experience
- Relevant 4 years’ experience in the medical field of which 1 year is on supervisory level.
- Experience in Managed health.
How to Apply for this Offer
Interested and Qualified candidates should Click here to Apply Now
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