Pre authorization Case manager at M&M Consulting
M&M Consulting Services and Talent Acquisition
- R40,000 per month
- Permanent Intermediate position
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Bryanston
- Posted 23 Apr 2025 by M&M Consulting Services and Talent Acquisition
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Job 2599015
About the position
- Pre authorise member's admission to hospital as per scheme protocol and guidelines
- Capture authorization on IMED system
- Liaise with medical advisor
- Handle hospital updates telephonically and via e-mails
- Telephonic and e-mail case management and referral of cases for Specialised case management as per guidelines
- Monitoring of ongoing hospital cases and final updates including negotiating for discounts
- Handle member's queries regarding hospitalization and benefits
- Handle written communication and motivation reports including correspondence
- Manage cost containment of hospital incidents/admissions
- Ensure maintenance of call centre SLA
- Liaise with hospitals, doctors, members and family members
- Work with other healthcare personnel within the organisation
- Provide clinical expertise within the organisation
Key: Responsibilities
1.Pre authorize member's admissions to hospital according to scheme benefits and departmental protocols and guidelines.
2. Manage high care and general ward cases up to a rand value of R70 000.
3. Telephonic case management of surgical cases up to a rand value of R80 000 and medical cases to R60 000 excluding joint replacements
REGISTERED NURSE
Desired Skills:
- Medical Schemes act
- Registered nurse
Desired Work Experience:
- 2 to 5 years Social Worker
Desired Qualification Level:
M&M Consulting Services and Talent Acquisition
About the agency
M&M Consulting Services as a business was established by its owners through the passion and commitment in serving people and Corporates, by
providing strategic partnerships to our clients, developing expertise of our client's environment, their challenges and other needs.
With over 14years experience in Human Capital, M&M Consulting Services has mainly focused on Managed Services and Recruitment and allowing businesses to focus on their core business. We combine our HR expertise with the knowledge of our client's environment to design, implement and
manage customized staffing solutions, resulting in improved business performance for our clients.
M&M Consulting Services is a SME, providing the flexibility most companies desire in the current economical state. We are ever changing and by doing so,we are able to blend in with the land scape changes.
WHAT WE DO
Partnering with key Stakeholders, Our vision is to be a proudly South African talent solutions provider, delivering the highest quality of service to clients and candidates.
We’re in the business of transformation, of both organizations and careers. Through the range of recruitment, talent management and recruitment process outsourcing solutions we offer, we help both organizations and individuals realize their full potential.
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