Specialist, Case Management (Philippines)

Cruise Administration Services Inc. (CASI), a Carnival Cruise Line entity in the Philippines currently has a Specialist, Case Management role available. Only candidates located in the Philippines to apply.

Job Summary:

This role reports to the Supervisor of Case Management to work towards obtaining high quality, cost effective, and timely health care for all hospitalized and non-hospitalized crew members. 

This role will work as a liaison between shipboard medical teams, the crew member and shoreside medical providers and assistance companies to promote appropriate medical care for crew members through the coordination of logistical aspects as well as medical evaluation to identify risks, trends, and /or missing actions throughout the cases. They will ensure that the appropriate documentation is kept.

The Specialist, Case Management will act as a health advocate and be responsible for cases from beginning to end, assisting crew with getting appropriate care and making decisions, receive the appropriate benefits related and ensure timeliness of communication and support from the company and review return to work.

The Case Management Specialist will also work with People’s Team / Crew Care / Travel Teams to ensure that crew members disembarked out of their domicile have the necessary medical care, is supported in hospitals / medical facilities, that appropriate transportation and hotel arrangements are available and that there is compliance with immigration / customs authorities. 

The Case Management Specialist will work closely with Assistance Companies with regards to care provided to Crew Members, but the focus will be dealing with high risk, long-term cases, high cost and complex cases to bring them to a timely conclusion and return to work where possible.

Position includes rotational on call to ensure 24-7 medical coverage.

This role will interface with all brands, medical teams onboard, shoreside health services and public health leaders as well as external vendors that manage our healthcare systems. Carnival Corporation is comprised of nine brands with approximately 95 ships carrying over 12 million guests annually and employing over 100,000 team members.  

Essential Functions:

Case Management:

• Engage with the Crew Member, Next of Kins, medical providers, and other stakeholders from moment of disembark to return onto the vessel. 
• The liaison between the shipboard medical team and shore-side medical providers to facilitate medical appointments, assist with retrieval and review of medical reports and documentation, and ensure timely communication with treating physician for general updates and/or recommendations on changes in course of treatment if necessary. 
• Act as the Healthcare Advocate for crew members who are medically disembarked, with focus for crew members admitted outside of domicile.
• Organizes the logistics for medical transfers of patients by any means (eg. Air Ambulances, Commercial Flights, Ground Ambulance, Medical escorts etc) from shipboard to shore-side, within shoreside and repatriation to their home country. 
• Determines fitness to work status based on Statutory and Company fitness standards while prioritizing patients’ health condition and minimizing sick time.
• Work with teams such as Crew Care / Care Team / Port Agents / Travel Teams and Assistance Companies to ensure that team members basic needs are met such as accommodation, food and communications with family while away from domicile.
• Work with Hospitals / Port Agents / HR teams and other authorities to ensure that appropriate requirements are met with regards parole and other customs requirements
• Ensures that cost estimates for medical procedures are provided and that they seem appropriate.  Reviews financial quotes and obtains management approval when not within the current margin of spending guidelines. Reviews and approves/rejects medically related invoices after referencing clinical chart details.   
• Maintains electronic medical documentation for each patient with case management, including updating medical history, case summaries.
• Maintain any appropriate communication logs of interactions with crew members, medical providers, and other stakeholders.
• Review and action cases in a frequent and timely manner
• Be part of a 24/7 On-Call Roster

Risk Management:

• Identifies high risk/catastrophic crew cases and alerts management accordingly. 
• Identifies patterns and/or trends in crew member illnesses and injuries
• Assist with and review of medical charts for quality assurance when required or requested in terms of complex cases. 
• Assist with and review of medical charts when required or requested for medicolegal purposes and coordinate with legal / claims and risks teams for mitigation of cases.
• Calls out any concerns or red flags as well as patterns related to medical providers

Operational Support:

• Work with the shipboard medical teams and health operations teams with regards to cases of medical disembarks of crew members.
• Provide assistance with projects or other requirements as operationally necessary.

Qualifications:

•  With Bachelor's degree. Clinical background, BSN/RN or MD required.
• 5+ years combined experience in patient care, case management, occupational health, and/or utilization review.  
• Familiarity and experience with medical billing procedures. Excellent organizational and communication skills.
• Proficiency in Microsoft Outlook, Word, Excel and PowerPoint Ability to handle multiple projects efficiently and complete in timely manner. Strong communication and organizational skills. Able to use PowerPlatform based applications
• Shipboard clinical experience preferred

• Amenable to work daily onsite in Pasay

   

#LI-PV1

#LI-Remote