Care Officer – Medical Job CIC Insurance

Purpose

Responsible for care facilitation/cost containment and call centre reachability.

Primary Responsibilities

  • Issuance of approval to insured members seeking both inpatient and outpatient care as per policy
  • Monitor cost, average length of stay on inpatient
  • 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
  • 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
  • Monitor benefits utilization and share timely updates to the
  • Prepare and share timely reports as may be guided.

Academic and Professional Requirements

  • Education    Diploma in Nursing or Clinical Medicine    E
  • Computer literate in MS Office and other office applications    E

Experience Required:

  • Two years Relevant experience in Care Management, medical claims and call centre 

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