Pre-Admissions Clinical Assessor

at Life Cosmos Hospital
Location Witbank, South Africa
Date Posted
Category Healthcare
Job Type FULL_TIME
Work Hours Day
Salary Units MONTH
Currency ZAR
Street Address Witbank

Description

 

A vacancy exists for a Pre-Admissions Clinical Assessor, based at Life Cosmos Hospital, Mpumalanga reporting to Charmaine van As, Patient Services Manager.  The successful candidate will be responsible for the management of the financial and clinical administrative risks pertaining to future patient admissions.

 

Critical Outputs

Manage pre-admission risk  -

 

Perform clinical assessments and document clinical history.

Ensure all pre-admissions are accurately clinically coded in accordance with the coding standards

Efficient and proactive pre-admission of all patients in accordance with Group protocol and close liaison with Case Management and National Credit Risk Departments to minimize risk exposure to the Hospital.

Ensure high standard of documentation and capture of relevant information for all admissions through hands on supervision and training.

Maintain a high level of customer focus amongst all staff at the Pre-Admission Clinic to the benefit of the Hospital, Public and Doctors.

Optimal management of bed and theatre bookings through close liaison with ward and Doctor’s rooms

Sound working knowledge and application of Funds relevant rules and limits.

Manage authorisations requests and benefit confirmations i.e. prosthesis benefit confirmation

Monitor insurance verification with funder

Monitor workflow processes

Identify and monitor gaps and risks and implement corrective actions accordingly.

Ensure effective management of quality outputs

 

Adhere to ISO 9001 standards

Perform quality walkabouts and implement corrective measures, where appropriate

Implement and monitor quality improvement programmes through power teams

Adhere to patient services escalation processes

Monitor Q-evaluator score and implement corrective measures, where appropriate

Investigate internal and external stakeholder complaints and take appropriate action

Drive adherence to customer service standards

Ensure and promote operational excellence

 

Drive compliance to LHC policies regarding authorisations and deviations

Implement corrective actions, where necessary

Monitor reports

Monitor and adhere to patient services policies and procedures

Ensure compliance to service level agreements with internal and external stakeholders

When operationally required, assist the case management team with case management duties and responsibilities.

Ensure effective management of relationships with internal/external stakeholders

 

Foster and maintain healthy relationships with internal stakeholders

Provide relevant feedback and information on concerns or issues raised by internal stakeholders

Implement corrective actions on deviations directly impacting on case management processes

Monitor of and advice on effective and regular communication with external stakeholders

Manage escalated concerns from Case Managers with external stakeholders

Requirements

Nursing Qualification, preferably Professional Nurse or Enrolled Nurse with at least five years’ experience

Current SANC registration

Knowledge of hospital patient services and case management processes

Knowledge and understanding of CPT & ICD coding

Knowledge of Funder contracts, scheme rules, exclusions and benefits

Understanding of private hospital industry and practices

Computer proficiency

 

Competencies

 

Problem-solving, analysis and judgement

Resilience

Engaging diversity

Verbal & written communication and presentation

Influencing

Drive & energy

Excellence orientation

Ethical behaviour

Building relationships

Customer responsiveness

Organisational awareness

Leading my example (Key for Managers)

Motivating and developing people (Key for Managers)

 

Interested candidates can send their CV

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