CASE MANAGER CITY HOSPITAL

Purpose of Position

To coordinate and manage patient care, funding, and discharge processes to ensure quality clinical outcomes, appropriate resource utilization, accurate reimbursement, and compliance with hospital and medical scheme requirements.

Key Performance Areas

• Support the implementation of the hospital's Case Management strategy and contribute to departmental objectives.
• Coordinate multidisciplinary care and discharge planning by collaborating with patients, families, medical practitioners, nursing staff, and medical schemes.
• Manage relationships with funders, ensuring timely communication, authorization management, and resolution of funding queries.
• Apply clinical knowledge to accurately code diagnoses and procedures using ICD-10 and CPT standards.
• Monitor patient admissions, length of stay (LOS), level of care (LOC), and discharge processes to ensure appropriate utilization and reimbursement.

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