Clinical Pre-Authorisation Consultant (CPT)

Clinical Pre-Auth Consultant (RN/ EN)
Location: Cape Town
Salary:  Market Related
REF: MVG/PreAuth
 
Our CAPE TOWN client, a managed care concern, seeks a candidate who will be responsible for ensuring the accurate issuing of appropriate pre-authorisation decisions that meet the requirements of clinical appropriateness, medical necessity and clinical risk management.
The role is performed within a contact centre environment.
 
Requirements:
  • Registered Nurse or Enrolled Nurse (Current registration with SANC essential)
  • 2 – 3 years’ experience in Trauma/ Medical/Surgical/ ICU Wards
  • At least 1 year experience at a private hospital
  • Previous Managed Care experience preferred
  • Knowledge of ICD Codes and Managed Care protocols would be advantageous
  • Must be able to demonstrate clinically-sound, cost-effective decision making that ensures and optimises the clinical outcome of the event
  • Computer literate – MS Word, Excel, Outlook (Non-negotiable)
  • Strong attention to detail and ability to work within a pressurised call centre environment
  • Excellent Customer Service skills and good work ethic secures
 
Please apply to response@mvgrecruitment.co.za  
Call: 0860 100 MVG (684) to enquire
 
Supporting documents:
  • Copy of ID
  • Copy of latest payslip
  • Copy of Matric
  • Copy of Nursing Qualification(s) 
  • Copy of SANC receipt