Care Officer – Medical At Cic Insurance

PURPOSE:
Responsible for care facilitation/cost containment and call centre reachability.
PRIMARY RESPONSIBILITIES:
Issuance of approval to insured members seeking both inpatient and outpatient care as per policy
Monitor cost, average length of stay on inpatient
Issue guidance on Pre-authorized optical, dental and scheduled procedures
Conduct Hospital visits whenever the insured members are hospitalized
Respond to stakeholder inquiries on cases involving medical care
Receive and respond to Medical emergency lines and ensure 24-hour coverage
Negotiate for discounts from doctors and hospitals on specific cases and procedures from time to time
Facilitate referrals and medical evacuations when need
Monitor benefits utilization and share timely updates to the
Prepare and share timely reports as may be guided.

Academic and Professional Requirements
Education Diploma in Nursing or Clinical Medicine E
Computer literate in MS Office and other office applications E

Experience Required:
Two years Relevant experience in Care Management, medical claims and call centre