A vacancy exists for a Pre-Admission Clinical Assessor, based at Life Empangeni Private Hospital, reporting to 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

Grade 12
Diploma or degree in Nursing, Physiotherapy, Clinical Associates, Paramedics as Critical Care Assistants or Emergency Care Practitioners or any other qualification that covers Anatomy, Physiology, Pathophysiology and Microbiology as foundational courses.
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
Building relationships
Customer responsiveness
Organisational awareness
Leading my example (Key for Managers)
Motivating and developing people(Key for Managers)
Ethical behaviour

Please send your resume/CV