About the role
Manages the financial and clinical risks of patients in specialised units and general wards through accurate coding, clinical updates and account submissions, and performs case-management administrative functions for patient events not requiring clinical updates – private, MVA, day cases and predictable admissions such as maternity.
Manages the financial and clinical risks of patients in specialised units and general wards through accurate coding, clinical updates and account submissions, and performs case-management administrative functions for patient events not requiring clinical updates – private, MVA, day cases and predictable admissions such as maternity.
Job Summary
- Type: full-time
- Location: Gaborone
- Category: Healthcare
- Closing Date: 2026-07-26
Key Responsibilities
- Ensure accurate ICD-10 & CPT coding and timely clinical updates on all patient accounts
- Obtain funder and insurance authorisations timeously before treatment; submit motivations and provide feedback
- Assist in managing the Oncology, Renal and Pre-Admission clinics; prepare and finalise theatre lists
- Monitor quality outputs, investigate stakeholder complaints and implement corrective measures
- Update length of stay, level of care and funds availability with medical aids; manage authorisations, claims, rejections and delays
- Apply funder rules and contracts correctly; action and close short-payment queries
- Train doctors and staff on funder contracts; escalate non-compliance under the risk framework
Requirements
- Nursing Diploma or Degree; registered with the Nursing and Midwifery Council of Botswana
- Minimum 3 years’ experience in case management and clinical coding (ICD-10 & CPT essential)
- Knowledge of hospital patient services and case management processes
- Knowledge of funder contracts, scheme rules, exclusions and benefits
- Understanding of the private hospital industry and practices
- Basic understanding of financial principles
- Computer proficiency
- Certificate or Diploma in Healthcare Management (desirable)
How to Apply
To apply, please visit: forms.gle
About the Company
A day hospital is an outpatient facility where patients attend for assessment, treatment or rehabilitation during the day and then return home or spend the night at a different facility. Day hospitals are becoming a new trend in healthcare. The number of surgical procedures carried out on a same-day basis has markedly increased in EU countries and USA. New medical technologies such as less invasive surgeries and better anesthetics have made this development possible. These innovations improve patient safety and health outcomes. Shortening the length of stay in hospital reduces the cost per intervention and increases the number of procedures performed. Less hospital beds are necessary, and they are often replaced by day hospital chairs that enable admission and preparation of the patient before surgery and recovery after surgery.
Frequently Asked Questions
What qualifications are typically required for a Case Manager role at a Day Hospital in Botswana?
Candidates usually need a diploma or degree in nursing, social work, or a related healthcare field, alongside relevant professional registration with bodies like the Botswana Nurses and Midwives Council. Practical experience in patient care coordination or hospital administration is often highly valued for this role.
What are the common day-to-day responsibilities of a Case Manager in a Botswana Day Hospital setting?
Day-to-day duties involve coordinating patient care plans, liaising with various healthcare providers and families, and ensuring smooth transitions for patients within the hospital and upon discharge. This includes managing resources, maintaining detailed patient records, and advocating for patient needs to optimize recovery and well-being.
What is the typical work culture and what are the expectations for a Case Manager in Botswana's healthcare sector?
The work culture emphasizes professionalism, empathy, and strong teamwork within multidisciplinary healthcare teams, often requiring cultural sensitivity and proficiency in local languages like Setswana. Employers expect dedication to patient advocacy, adherence to national health policies, and proactive problem-solving to ensure high-quality patient outcomes.
What are the realistic career progression or growth paths for a Case Manager in Botswana's healthcare industry?
Case Managers can advance to senior or supervisory roles within case management, overseeing teams or specialized programs, particularly with demonstrated leadership skills. Opportunities may also arise in health administration, quality assurance, or specific disease management programs, often requiring continuous professional development and further education.
What typical benefits can a Case Manager expect from a full-time role in a Botswana Day Hospital?
Full-time employees typically receive benefits such as medical aid contributions, pension fund schemes, and statutory leave entitlements including annual, sick, and maternity leave. Additional benefits might include professional development opportunities, depending on the specific employer's policies and the collective bargaining agreements in place.
How should I tailor my application, and what do employers in Botswana typically look for in a Case Manager candidate?
Emphasize your communication, organizational, and problem-solving skills, alongside any experience in patient advocacy or care coordination, within your CV and cover letter. Employers value candidates who demonstrate a strong understanding of Botswana's healthcare landscape, cultural competence, and a genuine commitment to patient-centered care.