Found Description
Case Manager Oncology (Internal)
Based in Gauteng, Eastern Cape, Western Cape and KwaZulu-Natal.
Case Manager Oncology (External)
Based in Gauteng and KwaZulu-Natal only.
Key Purpose
Management of enrolled oncology members by reviewing clinical appropriateness of treatment, applying Clinical Entry Criteria, protocols, SOPs, and clinical guidelines, and counseling members.
Key Outputs
- Enroll members on the oncology program ensuring all requirements are met.
- Review treatment plans against SAOC and Icon guidelines.
- Approve or decline treatment in line with SAOC/Icon and Discovery Health protocol.
- Refer complex cases to internal and external medical review teams and provide feedback.
- Communicate funding decisions to members, employers, and brokers verbally or in writing.
- Document notes on approval/decline and decision rationale.
- Identify risk and report ac...