Pharmacy Case Manager

LetsLink recruitment is currently seeking for a Pharmacy Case Manager to work at a private hospital in Gqeberha. The successful candidate will be responsible for liaising between patients and medical aids to ensure payment for hospital services.

Key Responsibilities:

• Ensure accurate and up-to-date information is entered into the Hospital Billing System
• Provide patient history details to clinical partners
• Monitor and control costs for managed care patients
• Confirm length of stay for managed care patients
• Participate in ward rounds to collect clinical information and provide updates to funders
• Release patient files
• Ensure correct coding (ICD and CPT) for all managed care patients
• Assist the Hospital Clinical Coder with clinical information to ensure accurate coding
• Consult with relevant service providers regarding patient care treatment
• Assist with patient transfers to rehab hospitals or step-down facilities
• Liaise with internal and external stakeholders to maintain managed care for patients
• Participate in in-service training provided by the organization
• Maintain a satisfactory level of skill and knowledge through professional development
• Work collaboratively with others to establish and maintain good working relationships
• Actively participate as a member of a team to achieve goals
• Maintain professional flexibility in working hours while supporting daily business hours
• Review accounts for short payments/Debt pack

Requirements:

• Registered or Enrolled Nurse qualification or equivalent NQF level 4
• Computer literacy
• Must be registered with the SANC or professional body
• Previous hospital or medical scheme case management experience is advantageous
• Experience in IDC 10 and CPT coding is advantageous
• Minimum of 3 to 4 years of experience in a multidisciplinary environment
• Ability to develop and maintain clinical knowledge
• Knowledge of case management skills and expertise
• Familiarity with nursing and pharmacy policies and procedures
• Understanding of managed healthcare experience
• ICD 10 and CCSA coding experience/qualification

If you are passionate about nursing and looking for an opportunity to take on a challenging role in a dynamic and growing organization, we would like to hear from you. Please submit your CV to vacancy at letslink dot co dot za or contact Gary on 011 0261907.

Please view our website: letslink dot co dot za and contact Gary.

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