Case Manager,Hospitals and Clinics (H/F)

Phénicia Conseil, recruiting on behalf of one of its clients—an international hospital infrastructure built on medical excellence, technological innovation, and long‑term sustainability—is seeking a highly qualified:

CASE MANAGER (H/F)

Location: Djibouti, local contract

Role Overview

The Case Manager plays a strategic role in coordinating clinical, financial, and administrative aspects of patient care. Acting as the link between clinical teams and Revenue Cycle Management, the Case Manager ensures medical necessity, payer compliance, timely insurance authorizations, optimized length of stay, and complete revenue capture.

Key Responsibilities

• Conduct utilization reviews and ensure medical necessity of admissions.
• Manage insurance authorizations and coordinate with payers for approvals.
• Monitor length of stay, identify discharge barriers, and facilitate timely discharge.
• Support clinical documentation accuracy to optimize coding and reimbursement.
• Coordinate multidisciplinary discharge planning from admission to discharge.
• Prevent revenue leakage through proper authorization and documentation.
• Participate in denial management, appeals, and payer performance reviews.
• Ensure compliance with hospital policies, insurance regulations, and accreditation standards.
• Prepare analytical reports on LOS, denials, utilization trends, and high‑cost cases.

Qualifications & Experience

• Bachelor’s Degree in Nursing or related healthcare field.
• Valid professional license (or eligibility to obtain one).
• 5+ years clinical experience in acute care preferred.
• 2+ years in Case Management, Utilization Review, Insurance Coordination, or Revenue Cycle.
• Knowledge of DRG, ICD‑10, CPT, payer authorization processes.
• Strong analytical, communication, and negotiation skills.
• Experience with HIS/EMR systems; familiarity with JCI standards is an asset.
• English and French Language as a Must

Envoyez votre CV et lettre de motivation à : paolo.bossi@recrutement-phenicia.fr