Position based in Madrid, Spain. We may consider having someone remote from Poland if needed. We are looking for a Case Manager, with an empathic, can-do attitude who is passionate about service delivery and eager to make an impact on people's lives at the most vulnerable moment for them - through the pathway of a critical illness. This role will be constantly enhancing the quality of the Patient's journey and delivering a 5-star Customer experience at each interaction.
As our Case Manager, you'll get to:Provide support to incoming cases and confirm policy, as well as medical eligibility according to internal process.Coordinate and provide access to the best specialists and health care providers in a timely and effective manner.Support the insured member to understand the products, process, and clinical journey.Interact directly with Customers and Families along the Customer journey for intake interviews and others, keeping track of their progress and ensuring satisfaction.Organize internally with Medical Panel and externally with Medical Providers to establish a clear pathway for treatment recommendation and consequent services.Review medical reports and treatment plans and control medical costs triggering the appropriate level of authorizations.Handle assigned cases, draft service plans, review case progress and determine case closure.Help insured members make informed decisions by acting as their advocate regarding their clinical status and treatment options.Develop effective working relations and cooperate with internal Teams and colleagues, especially the medical team throughout the entire case management process.Collaborate and coordinate with international TPA's wherever and whenever applicable.Maintain all case records completed and up to date within internal systems (i.e., record case information, complete accurately all necessary forms, produce reports).Use the clinical background and knowledge to provide guidance and support to Claims Coordinators and other colleagues.Adhere to professional standards as outlined by protocols, rules, and regulations.We'd love to meet someone who has:University Degree in Nursing, or similar clinical qualifications.Clinical experience.1-2 years of professional experience in a similar role, ideally from an international health/insurance-oriented business is a plus.Understanding of the customer operations or Patients' Care processes.Excellent verbal and written communication skills in English; any other language will be considered an asset.Strong interpersonal skills, empathetic.High attention to detail, organized and structured mind.Strong can-do attitude.Experience in problem resolution.Ability to multi-task, organize and prioritise work.Salary: 21,000.00€ - 25,000.00€ per year
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