Senior Case Management Specialist

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For over 30 years, APRIL International Care has been specializing in international health insurance solutions. We design, distribute, and manage insurance plans and assistance services for individuals and businesses. With teams across Asia, Europe, and the Americas, we look after our members wherever they are to ensure they have access to the best care. We are part of the APRIL Group, an insurance specialist with 2,300 staff in 16 countries. If you are a proactive and compassionate professional with a passion for enhancing customer experiences and optimizing healthcare solutions, we invite you to apply for the Senior Case Management Specialist in APRIL International.

Responsibilities

Your mission: Manage complex case management cases within the APAC region ensuring that members receive the best treatment at a reasonable cost while navigating the intricacies of healthcare systems.
• Develop a comprehensive understanding of each medical case to provide tailored support.
• Ensure the medical appropriateness of treatment plans by adhering to evidence-based medicine, and challenge providers when necessary to advocate the member’s best interests.
• Engage with members regarding their healthcare situations, offering guidance and discussing alternative treatments. Facilitate second medical opinions when needed and provide strategic recommendations.
• Implement innovative cost containment actions for each case to tackle the medical inflation and prevent abuse and over prescription.
• Negotiate directly with healthcare providers, including Hospital and Doctors, to secure the best possible outcomes for members.
• Execute cost control strategy to achieve cost savings while enhancing the overall customer experience.
• Provide support and guidance on complex situations to other team members.
• Organize regular case study sessions to foster teamwork, communication, and collaboration among team members, creating a supportive work environment.
• Escalate cases as needed, offering detailed information and actionable suggestions for effective handling.
• Collaborate closely with the Regional Head of Medical to execute strategies and objectives.

Requirements

• Medical degree in any specialty
• Previous experience in insurance or assistance sector would be a plus
• Exceptional communication skills and convincing skills
• Proven experience of effective costs negotiation
• Organizational and detail-oriented skill
• Proven ability to work collaboratively in a team-oriented environment while also being capable of working independently with minimal supervision
• Fluency in English is required