SENIOR OFFICER FIELD CASE MANAGEMENT

T.A.S.K GRADE 12
SOFCM18022022CPT
LOCATION: Cape Town
CLOSING DATE & TIME: 1/3/2022 11:55 PM
Purpose of the Job: To manage the rehabilitation and healthcare needs of the injured.

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 collaborations 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 resolutions 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 resources utilization

  • Post discharge follow-through
  • Drug utilization review
  • Assistive devices necessary for client
  • Home alterations
  • Vehicle adaptations
  • Vocational guidance after life changing event for the 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 advises claimants of outcomes of bill review

Recommend payment

  • Recommend payment of bills assessed

Qualifications & Experience

  • NQF 6 (Diploma or Advanced Certificate) in Nursing or Allied Health Professions or related qualification to discipline
  • NQF 7 (Bachelor’s Degree or Advanced Diploma) in Nursing/ Applied Health Professions related qualification to discipline will be an added advantage
  • Registration with the relevant Health professions council
  • Knowledge of ICD and CPT coding will be an advantage
  • Valid code 8 driving license
  • Relevant of 4 years’ experience in the medical field of which 1 year is on supervisory level
  • Experience in Managed Health

Technical and Behavioural competencies required

  • Organisational Resilience
  • Team Resilience
  • Network and Alliances
  • Personal Mastery
  • Judgement and Decision Making
  • Emotional Wisdom
  • Ethics and Governance
  • Customer orientation and customer focus
  • People oriented
  • Team player.
  • Adaptability, flexibility and creativity
  • Interpersonal & communication skills
  • Strong sense of self-esteem, confidence and confidence
  • Good follow-through
  • Self-directedness
  • Caring attitude and behaviour
  • Assertiveness Skills
  • Analytical skills 

Road Accident Fund Values

  • Integrity,
  • Compassion,
  • Accountability,
  • Respect,
  • Excellence

Remuneration
The total cost to company minimum remuneration package applicable to this position is R502 953.00per annum and will be negotiable commensurate with experience.       

Closing Date: 01 March 2022

NB: “RAF offers Total Employment Cost packages with no additional contributions from the Employer, successful candidates are required to structure their packages in manner that will suit their needs”.

APPLICATIONS CAN BE FORWARDED FOR ATTENTION OF THE RECRUITMENT OFFICER AT:CPTRecruitment@raf.co.za

INSTRUCTION TO PROSPECTIVE APPLICANTS

  1. Indicate the name, and the reference number for the position you are applying for on the subject line
  2. Do not submit copies of qualifications and ID as these will be requested from shortlisted candidates on the interview date
  3. Preference will be given to people with disabilities
  4. It is the applicant’s responsibility to have foreign qualifications evaluated by the South African Qualifications Authority (SAQA) and to provide proof for such evaluation
  5. Submit a short CV with a maximum of 5 pages

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