Job Description:

About the Job

The Care Officer is responsible for care facilitation/cost containment and call centre reachability.

Responsibilities

Issuance of approval to insured members seeking both inpatient and outpatient care as per policy guidelines.
Monitor cost, average length of stay on inpatient cases.
Issue guidance on Pre-authorized optical, dental, and scheduled procedures.
Conduct Hospital visits whenever the insured members are hospitalized.
Respond to stakeholder inquiries on cases involving medical care management.
Receive and respond to Medical emergency lines and ensure 24-hour coverage.
Negotiate for discounts from doctors and hospitals on specific cases and procedures from time to time.
Facilitate referrals and medical evacuations when need be.
Monitor benefits utilization and share timely updates to the stakeholders.
Prepare and share timely reports as may be guided.
May be required to travel to distant branches or wherever the Company has any interest.
May be required to work extended working hours to ensure jobs are completed on schedule and to specification.

Requirements

Diploma in Nursing or Clinical Medicine.
2 years of relevant experience in Care Management, medical claims, and call centre.