about the company
Our client, a global leading health insurance company.
about the job
In this position as a Clinical Case Manager, you will be reporting to the Clinical Service Manager and responsible for individual case management of medical cases as specified by the business to ensure quality care with special focus on balancing financial savings.
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The ideal incumbent is expected to investigate and respond to enquiries for complex medical authorisations and high value within certain threshold and criteria claims from members, providers, group secretaries, service partners
and intermediaries in the appropriate method. You will pro-actively contact members, providers, service partners and intermediaries via telephone, email, fax and letter to advise on decision of request and fully explain benefit entitlement to all parties and liaising with Global clinical staff to interpret condition and treatment respectively.
The ideal incumbent needs to proactively negotiate medical costs and/or medical treatment to achieve either reduced cost to the business or most appropriate treatment for member and support the medical teams to provide provider/specialist recommendation, estimate medical costs helping make appointment, support case management, etc. Achieve departmental and individual KPIs.
skills and experience required
- Excellent medical background with practical medical experience
- Experience in Doctor / Surgeon Fee Negotiation primarily in Singapore and Southeast Asia
- Proficient knowledge of the Singapore Ministry of Health Table of Surgical Rates with experience in Surgical Fees Benchmark
- Excellent communication skills and service oriented attitude
- Office based role, hybrid work arrangement
- Benefit includes annual leave, medical benefits & bonus
** Role will require the individual to work 12hours shift and 5 days a week. Applicant must be comfortable working on weekends or PH depending on schedule**
If the above position interest you, kindly click on the appropriate link to apply for this role.
EA: 94C3609/R132534
Applicants must be fully vaccinated or have a valid exemption in accordance with MOM’s regulations to allow them to enter the workplace. Applicants may be required to share verifiable COVID-19 vaccination documents or proof of a valid exemption at the point of offer. Randstad Pte. Limited and/or the Client reserves the right to withdraw an offer if the applicant fails to provide verifiable COVID-19 vaccination and/or proof of exemption documents.