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Clinical Case Manager
2 months ago
We are seeking a highly skilled Clinical Case Manager to join our team at MSH Americas - Diot-Siaci Group. As a key member of our clinical operations team, you will be responsible for managing a large caseload of medical cases, providing expert medical opinion, and ensuring compliance with all procedures and processes.
Key Responsibilities- Manage a large caseload of medical cases, including medical reviews and validations
- Provide expert medical opinion regarding medical necessity, length of stay, and reasonable and customary charges
- Comply with all procedures and processes established for all medical teams
- Review and release high claims, including notifications for high-dollar cases
- Monitor high-cost pharmacy expenses
- Participate in new projects as needed
- Summarize medical information in a clear and concise manner
- Facilitate commercial or medevac repatriations
- Effectively communicate and document all interactions in the appropriate platform
- RN, RPN, or unlicensed MD (Canada) from another country
- Minimum 3 years of experience as a Case Manager
- Customer service experience
- Excellent verbal and written communication skills in English
- Superior time management skills
- Resourcefulness
- Ability to communicate diplomatically
- Ability to work in a fast-paced and dynamic environment
- Hybrid work environment
- Excellent health benefits
- Employee assistance program
- Wellness account
- RRSP matching
- Minimum 3 weeks' vacation
- Generous allowances for sick and flex days
- Tuition reimbursement program
- Opportunities to learn new skills, grow, and move into different roles
