Care Coordinator - Singapore - Cigna Health and Life Insurance Company
1 month ago
Description
Job Responsibilities:
Manage the pre-authorization process for cases in Singapore, assessing proposed treatment and therapies for medical necessity, in accordance with global medical guidelines.
Use clinical knowledge to assess diagnosis and treatment plans and goals and identify gaps in care or risks for readmission or complications.
Interface with the member, family members/caregivers, and the healthcare team, as well as internal matrix partners.
Balance business needs with patient advocacy.
Assess member's health status and treatment plan and identify any gaps or barriers to healthcare.
Coordinate care for customers by reviewing medical and claim information, ensure compliance with approved services and fees and discuss cases with hospital staff and physicians.
Establish a documented patient centric case management plan involving all appropriate parties (client, physician, providers, employers, etc.), identify anticipated case results/outcomes, criteria for case closure, and promote communication within all parties involved.
Deliver to customers clinical programs including case management, chronic condition management, lifestyle coaching, pre assignment assessment and any other program delivered by global clinical operations.
Adhere to professional practice within scope of licensure and certification quality assurance standards and all case management policy and procedures.
Participate in unit and corporate training initiatives and demonstrate evidence of continuing education to maintain clinical expertise and certification as appropriate.
Play an active role towards Cigna ́s digital transformation.
Serve as clinical liaison to Clients.
Key Challenges/Anticipated Changes in Environment:
Demonstrate sensitivity to emotionally distressed and culturally diverse situations, clients and customers.
Manage/coordinate an active volume of cases by providing information and coordination to customers worldwide in a multicultural population.
Coordinate care with other Cigna Case Managers around the world when a need for local or regional expertise is important for better care or to comply with regulations.
Developmental Value:
Gain experiences and knowledge within the insurance and healthcare industry.
Broad exposure to all aspect of business operations and to develop leadership/general management skills.
Continue to utilize and enhance healthcare knowledge while out of clinical setting.
Job Requirements:
Bachelor's degree in nursing.
Clinical knowledge to assess diagnosis and treatment plans and goals and identifies gaps in care or risks for readmission or complications.
Strong organizational and leadership skills.
Strong interpersonal and communication skills.
Demonstrates problem-solving and analytical skills.
Ability to build excellent working relationships with staff, matrix partners, customers and providers.
Ability to act as an "advocate" for the customer while complying with internal Policies and procedures and contractual/legal compliance requirements.
Enthusiastic with a positive attitude.
Ability to operate computer, proficient with Microsoft office products, call center software, and a variety of software.
About The Cigna GroupCigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life.
We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality.
Join us in driving growth and improving lives. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve.Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients.
Join us in driving growth and improving lives.#J-18808-Ljbffr