International Assistance Nurse Case Manager (Medical Insurance)

TL;DR

International Assistance Nurse Case Manager (Medical Insurance): Providing clinical analysis and oversight for medical records to determine necessity and care plans with an accent on cost containment and evacuation/repatriation. Focus on risk assessment of high-risk cases and coordinating multidisciplinary medical and operational teams.

Location: Hybrid or onsite in the United States. Candidates must be legally authorized to work in the US; sponsorship is not provided.

Company

One of the world's top International Medical Insurance companies providing global peace of mind to travelers and expats.

What you will do

• Review and analyze medical records to provide direction on medical necessity and proposed plans of care.
• Evaluate evacuation and repatriation requirements for high-risk cases.
• Implement cost containment strategies and provide guidance on claims status regarding acute or pre-existing conditions.
• Collaborate with equipment managers and flight teams to ensure commercial escorted repatriations are appropriately augmented.
• Provide travel advice and health education to individuals and corporate groups via telephone and email.
• Maintain PHI confidentiality and participate in quality management activities.

Requirements

• Active Registered Nurse (RN) license in good standing.
• Minimum 5 years of experience in acute care fields such as the Emergency Room or ICU.
• Must be legally authorized to work in the United States (no sponsorship provided).
• Proficiency in Microsoft Word, Excel, and general internet usage.
• Strong clinical judgment and ability to interpret complex medical data.

Nice to have

• Experience with aeromedical retrievals or insurance case management.
• Familiarity with preauthorization procedures.
• Personal or professional experience with international travel.
• Foreign language skills.
• Experience in mentoring and teaching peer groups.

Culture & Benefits

• Comprehensive health package including Medical, RX, Dental, Vision, and Life insurance.
• 401k plan with company matching.
• Paid Time Off and company-paid holidays.
• Tuition reimbursement plan.