Senior Case Management Specialist

Your mission: Manage complex case management cases within the APAC region ensuring that members receive the best treatment at a reasonable cost while navigating the intricacies of healthcare systems.
Case management
• Develop a comprehensive understanding of each medical case to provide tailored support.
• Ensure the medical appropriateness of treatment plans by adhering to evidence-based medicine, and challenge providers when necessary to advocate the member's best interests.
• Engage with members regarding their healthcare situations, offering guidance and discussing alternative treatments. Facilitate second medical opinions when needed and provide strategic recommendations.
Cost Control
• Implement innovative cost containment actions for each case to tackle the medical inflation and prevent abuse and over prescription.
• Negotiate directly with healthcare providers, including Hospital and Doctors, to secure the best possible outcomes for members.
• Execute cost control strategy to achieve cost savings while enhancing the overall customer experience.
Team Collaboration:
• Provide support and guidance on complex situations to other team members.
• Organize regular case study sessions to foster teamwork, communication, and collaboration among team members, creating a supportive work environment.
• Escalate cases as needed, offering detailed information and actionable suggestions for effective handling.
• Collaborate closely with the Regional Head of Medical to execute strategies and objectives.