Care Officer 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 guidelines
• Monitor cost, average length of stay on inpatient cases
• 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 management
• 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 be
• Monitor benefits utilization and share timely updates to the stakeholders
• Prepare and share timely reports as may be guided

Academic And Professional Requirements

• Minimum Qualification – Diploma in Nursing or Clinical Medicine

Experience Required:

Two years of relevant experience in Care Management, medical claims and call centre