Case Manager - Hospital Benefits Management

As the leading medical recruitment agency in South Africa, our client has an exciting opportunity for a Case Manager – Hospital Benefit Management to be based in Pretoria, South Africa.

The Client

Our client is a dynamic healthcare organisation that is passionate about improving access to quality care through efficient and clinically sound health benefit management. Their multidisciplinary team delivers technology-driven, patient-centric solutions across the healthcare continuum.

The Opportunity

This position plays a pivotal role in managing hospital cases through accurate, evidence-based funding decisions. You’ll work closely with healthcare professionals and funders to ensure the delivery of cost-effective, appropriate, and quality healthcare services for patients.

Key Responsibilities

• Conduct case management reviews for hospital admissions and related services

• Liaise with service providers to coordinate hospital care and discharge planning

• Monitor patient progress, treatment plans, and appropriateness of care

• Apply scheme rules, funding guidelines, and clinical protocols consistently

• Provide accurate documentation and reporting for funding approvals

• Collaborate with multidisciplinary teams to ensure optimal patient outcomes

• Support hospital benefit management initiatives and audits

Requirements

• Registered Nurse with SANC registration (essential)

• Minimum 3 years’ experience in hospital case management or funder environment

• Knowledge of managed care principles and funding protocols

• Excellent communication and clinical decision-making skills

• Strong understanding of private healthcare and medical scheme processes

• Computer literacy with proficiency in clinical and administrative systems

Benefits

• Competitive market-related salary package

• Stable Monday–Friday working hours

• Supportive and innovative working environment

• Opportunities for professional development

Location: Pretoria, South Africa

Apply Now

If this vacancy is closed or you have any questions please contact apply@medipath.co.za Please be advised that you will be contacted by Medipath Healthcare Recruitment within 14 days should we wish to proceed with your application. Similarly, if you are not contacted by Medipath Healthcare Recruitment, please accept your application as unsuccessful. Your CV will automatically be added to our database and we could be contacting you should a suitable position arise.