Aileen Fowler
Case Manager
Hopefield
Summary
Dynamic case manager with extensive experience at Liberty Health, excelling in pre-authorization and case management. Proven problem-solving and decision-making skills, enhancing operational efficiency. Adept in documentation and reporting, ensuring compliance and accuracy. Recognized for training new staff and improving patient satisfaction through compassionate care.
Overview
37
37
years of professional experience
Work History
Case Manager
Liberty Health
02.2009 - Current
- Management of all Pre-authorisation and case management request, subject to available benefits and clinical protocols.
- Call centre supervisor for Liberty Health pre-authorisation call centre
- Assisted in managing our 24hours EVAC phone for our members.
- Involved in training of all new case managers with systems and case management process and coding.
- Involved in auditing and peer review process for case managers.
- Dental management assistance
- Rehabilitation / wound care management assistance
- Case investigations for possible duplication / fraud.
- Assistance to in country case managers in case management.
- Staff member of Liberty OHS(occupation health and Safety ) team.
Pre-authorisation and Case Management Agent
Sanlam Health / Medscheme
02.1997 - 01.2009
- Pre-authorisation call centre agent
- Dental case manager
- Maternity case manager
- Neonatal case manager
- General case manager
Enrolled Nurse
SASSAR Retirement Centre
04.1992 - 01.1997
- General nursing assistance to patients and management of staff workload
- Administered medications via oral, intramuscular injections and monitored responses.
- Performed routine wound care and dressing changes on schedule.
- Improved patient satisfaction ratings by delivering compassionate and personalized care.
- Performed accurate documentation of patient assessments, interventions, and outcomes in compliance with regulatory standards.
- Remained calm during high-stress, critical situations, demonstrating sustained focus and problem-solving in real-time.
Enrolled Nurse
Tygerberg Hospital
01.1988 - 03.1992
- Training at Tygerberg Hospital
Education
Diploma in Nursing - Nursing
Tygerberg Hospital
Parow, Cape Town 04.2001 -
Skills
Case management
Clinical coding courses - Sanlam Health/Medscheme
Problem-solving
Decision-making
Records management
Email and telephone etiquette - Sanlam Health/Medscheme - 1997 -2009
Documentation and reporting
Organization and multitasking
Conflict resolution
Case documentation
MS office - Excel, Word, Powerpoint and MS teams
Time management
Timeline
Case Manager
Liberty Health
02.2009 - Current
Diploma in Nursing - Nursing
Tygerberg Hospital
04.2001 -
Pre-authorisation and Case Management Agent
Sanlam Health / Medscheme
02.1997 - 01.2009
Enrolled Nurse
SASSAR Retirement Centre
04.1992 - 01.1997
Enrolled Nurse
Tygerberg Hospital
01.1988 - 03.1992
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