NURSE CASE MANAGER

NURSE CASE MANAGER

NURSE CASE MANAGER

POSITION SUMMARY

Coordinate comprehensive (medical, social etc.) health care services for beneficiaries of the Treatment Abroad Program. Assist in the development and implementation of approved and appropriate treatment plans for the beneficiaries. Interface with the network of medical providers in regard to client care. Provide daily supervision of Patient Services Coordinators.

REPORTING RELATIONSHIPS

Reports to: Directly to: Clinical Services Manager/Medical Director

 Indirectly: Chief Executive Officer

 Supervision: Senior/Junior Patient Services Coordinators

DUTIES AND RESPONSIBILITIES

• Works with providers and claims officers to coordinate and assure proper delivery and oversight of medical services.
• Utilizes clinical/nursing skills to collect, review and analyze health data from medical records and/or other sources as provided.
• Evaluates and coordinates medical services using cost containment strategies.
• Adheres to all appropriate privacy, security, and confidentiality policies and procedures.
• Participates in the orientation of new employees, as assigned.
• Actively participates as a contributing team member as demonstrated by attitude, cooperation, shared problem solving and participation in projects.
• Gathers relevant data and information by conducting clinical interviews with beneficiary and the provider(s).
• Assesses and identifies barriers to recovery; determines goals, objectives, and potential alternatives to care.
• Facilitates and promotes timely and effective communication between all parties involved.
• Monitors and evaluates case management outcomes and identifies case management approaches; over or under utilization, inappropriate care, effective treatment, permanent or temporary loss of function, failed or premature return-to-work, noncompliance, etc.
• Acts as a strong problem solver utilizing analytical ability and demonstrating this competency through communication, organization and interpersonal skills.
• Enforces cost-reduction strategies and recommend options in the management of claimant’s care.
• Prepares reports on request for specific medical services to the Clinical Services Manager/Medical Director.
• Participates in continuous improvement activities.
• Participates in on call duties as scheduled.
• Performs other related duties assigned by the Clinical Services Manager/Medical Director.

REQUIRED EDUCATION EXPERISE/SKILLS

This position requires: 

• Registered Nurse
• A Bachelor’s Degree in Nursing or Health Service Administration or equivalent.
• Five years’ experience in healthcare service delivery setting
• Knowledgeable in the law (Benefits and Assistance Regulations) pertaining to Industrial Accidents;
• Knowledgeable in health insurance and medical coding/billing practices
• Effective, interpersonal, communication and customer service skills
• Registered Nurse with well-rounded experience in medical case management, including, but not limited to rehabilitation, emergency, critical care, and health care administration;
• Certification in case management is a plus.
• Certificate of Good Standing to practice Nursing in current jurisdiction
• Administrative/Management experience is an asset
• Must be able to use Microsoft Office Suite (Word, Excel, and Power Point etc.). 
• Excellent team player with team building skills.  
• Excellent written and oral communication skills. 
• Ability to deliver to strict deadlines and to work under pressure.

SALARY:

Salary will be commensurate with qualifications and experience.  Up to $49,920 per annum not including On-Call Allowance

All Applications should be addressed to:

Sheena Smith-Yip

National Health Insurance Board

64-66 Saltmills Plaza

Providenciales

Turks and Caicos Islands

British West Indies

Please ensure the application demonstrates how you meet the noted qualifications, as applicants will be screened based on the information provided. We would like to thank all applicants for their interest. However, only those who are selected for an interview will be contacted. Applicants who applied for any of the above listed positions do not have to reapply. Qualified Belongers may also submit a copy of their applications to the Commissioner of Labour & Immigration Board after submitting applications to the National Health Insurance Board Human Resource department.

Deadline for submission is 30 September 2023