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clinical case manager.

job details

summary

    job details

    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.

    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
    • 4+ years of experience as a Nurse in hospital environment
    • Confident liaising with Doctors on medical schedule/procedure/medication
    • 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 12 hours 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.

    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.

    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
    • 4+ years of experience as a Nurse in hospital environment
    • Confident liaising with Doctors on medical schedule/procedure/medication
    • 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 12 hours 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.