Case Manager

Job Description:
Global Excel Management works with Canadian, International Insurers and prestigious brands. We are looking to compliment our dedicated, goal-oriented team. GEM provides services to individuals who have purchased a travel insurance policy and need assistance on their trip or to submit a claim. We are seeking driven, career-minded individuals to fill several positions within our growing company. We offer a competitive salary, potential for growth and invest in you by providing full training and opportunities for advancement.

The Role

The Case Manager is a health care professional that assesses and manages our clients’ medical emergencies while travelling. With in-house Case Management training and utilizing proprietary networks and tools, the Case Manager is able to uncover the clinical facts, facilitate access to appropriate health care regardless of location, and work with local health care providers to coordinate a patient’s safe transition back home. At the same time, the Case Manager works with our Emergency Assistance, Case Management, and Claims teams to determine what a clients’ travel policy covers and ensure that medical expenses are appropriate and necessary.

Responsibilities

Communicate with health care providers worldwide to obtain the clinical status of an insured’s medical condition;

Assess the appropriateness of proposed medical treatment with the support of GEM Medical Directors;

Initiate and coordinate medical patient transfer in collaboration with Case Coordinators to promote client safety and contain cost;

Identify the acuity and anticipated medical management of a clinical presentation to inform case strategy and implementation;

Analyze clinical information and communicate the impact on eligibility for coverage to internal and external stakeholders;

Educate health care providers on the role of travel insurance and medical benefits available to the insured;

Review, summarize and analyze client medical records;

Use case management software to accurately and concisely document all call details and actions taken/required;

Provide professional mentorship of Case Management Team;

Perform other duties as assigned.

Skills and Requirements

University Degree/College Diploma in Nursing or equivalency medical training;

Current license in good standing with the College of Nurses of Ontario and membership with RNAO (if an RN);

At least two years of clinical experience in a hospital/community setting;

Experience in ICU/ER an asset;

Handle/communicate and exchange sensitive and confidential information in a professional manner;

Excellent written and verbal communication skills with proven ability to communicate medical terms/concepts to diverse groups, including medical professionals and the general public;

Able to handle fluctuating work volumes in a fast paced, customer focused environment;

Able to work independently or in a team;

Proven ability to prioritize work responsibilities to achieve best possible outcomes;

Basic understanding of travel insurance, insurance terminology and case management is an asset;

Strong computer skills (Windows, Excel, typing);

Able to work various shifts and days of the week as required.

We offer you:
37.5-40 hour work week;

Room for growth and advancement;

Social committee;

Wellness Program;

Good work/life balance;

Onsite cafe offering fresh food for purchase;

Bilingual bonus when applicable.