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Case Manager - Medical Case Management

Hybrid
Windsor, ON
Senior Level

About the role

Job Description:

Are you a people person with a knack for providing excellent customer service? Are you interested in working in a multilingual and friendly environment that encourages personal and professional development? We would love to meet you! Global Excel Management works with Canadian, International Insurers and prestigious brands, provides services to individuals who have purchased a travel insurance policy and need assistance on their trip or to submit a claim.

As a Case Manager, you are a health care professional who will assess and manage our clients’ medical emergencies while travelling. With in-house Case Management training and utilizing proprietary networks and tools, the Case Manager is able to uncover the clinical facts, facilitate access to appropriate health care regardless of location, and work with local health care providers to coordinate a patient’s safe transition back home. At the same time, the Case Manager works with our Emergency Assistance, Case Management, and Claims teams to determine what a clients’ travel policy covers and ensure that medical expenses are appropriate and necessary.

What does your typical day look like?

  • Communicate with health care providers worldwide to obtain the clinical status of an insured's medical condition;
  • Assess the appropriateness of proposed medical treatment with the support of GEM Medical Directors;
  • Initiate and coordinate medical patient transfer in collaboration with Case Coordinators to promote client safety and contain cost;
  • Identify the acuity and anticipated medical management of a clinical presentation to inform case strategy and implementation;
  • Analyze clinical information and communicate the impact on eligibility for coverage to internal and external stakeholders;
  • Educate health care providers on the role of travel insurance and medical benefits available to the insured;
  • Review, summarize and analyze client medical records;
  • Use case management software to accurately and concisely document all call details and actions taken/required;
  • Provide professional mentorship of Case Management Team while also performing other duties as assigned;
  • Able to work various shifts and days of the week as required, primarily day shift with rotating evenings and weekends;
  • Hybrid work model post completion of orientation.

What skills and training do you need?

  • University Degree/College Diploma in Nursing (RN/RPN) or equivalency medical training;
  • Current license in good standing with the respective provincial nursing governing body;
  • At least one year of clinical experience in an acute care setting;
  • Experience in ICU/ER an asset;
  • Handle/communicate and exchange sensitive and confidential information in a professional manner;
  • Excellent written and verbal communication skills with proven ability to communicate medical terms/concepts to diverse groups, including medical professionals and the general public;
  • Able to handle fluctuating work volumes in a fast paced, customer focused environment;
  • Able to successfully work independently and in a team;
  • Proven ability to prioritize work responsibilities to achieve best possible outcomes;
  • Proactive approach to case management, anticipating needs and taking necessary steps to ensure success;
  • Basic understanding of travel insurance, insurance terminology and case management is an asset;
  • Strong computer skills (Microsoft System including Word, Excel, Teams, Outlook etc.), with the ability to work multiple systems at one time;
  • Ability to multi-task, while maintaining strong organizational and prioritization skills.

When you apply:

If you require assistance or accommodation during our recruitment process, please notify Human Resources so that we can review and consider how we may be able to assist you based on your individual needs.

About Global Excel Management Inc.

Insurance
501-1000

Global Excel is a full-service provider of global healthcare risk management solutions. Global Excel, together with its subsidiaries based in Canada, USA, Mexico, Europe, Africa, and Asia, offers a complete range of risk mitigation, cost containment, claims management and medical assistance services to over 1800 clients located in more than 90 countries around the world. As a group, Global Excel will manage approximately 420,000 inpatient, outpatient and non-medical cases per year and processes in excess of $1.95B USD in healthcare claims annually.

The Global Excel family encompasses over 1500 employees internationally located in Sherbrooke, Canada, in Windsor, Canada, Miami, USA, Mexico City, Mexico, Europe and Africa, as well as Jakarta, Indonesia.

Gestion Global Excel Inc. est un fournisseur de solutions globales complètes dans la gestion des risques associés aux soins de santé. Global Excel et ses filiales, dont les bureaux se situent au Canada, aux États-Unis, au Mexique, en Europe, en Afrique et en Asie, offrent une gamme complète de services d’atténuation des risques, de contrôle des coûts, de gestion des réclamations et de services d’assistance médicale à plus de 366 clients répartis dans plus de 90 pays à travers le monde. En tant que groupe, Global Excel gère près de 360 000 cas médicaux et non médicaux annuellement, et ce, en milieu hospitalier et en consultation externe. Notre entreprise traite plus de 1,9 milliard de dollars US en réclamations associées aux soins de santé par an.

La famille Global Excel emploie plus de 900 employés aux quatre coins du monde situés à Sherbrooke, Canada; à Windsor, Canada; à Miami, États-Unis; à Mexico, Mexique; en Europe; en Afrique ainsi qu'à Jakarta, Indonésie.