Medical Case Manager

Medical Case Manager

Benefits

Competitive Salary, Pension, Health Insurance, Life Insurance, Luncheon Allowance and more, including excellent career development opportunities

Hours

35 hours per week on a variable shift pattern between the hours of 8am and 8pm Monday to Sunday.  These hours will vary in line with business needs and flexibility is required

The Role

You will be required to prioritise and manage a caseload of patients overseas or in the UK and assess each case taking into account the following:

• Medical need
• Local facilities
• Age of patient
• Cost of care

You will need to be confident in providing advice and recommendations on the management and repatriation requirements for each individual and will be aware of the limitations of travel for sick and injured individuals in addition to possessing in depth knowledge of the relevant airline medical clearance guidelines.

You will also be involved in providing medical support and advice to the International Medical Team enabling them to manage cases more effectively.

Main Duties

Case Management

• Demonstrate advanced knowledge, skill and competency in the assessment of individual cases
• Perform initial telephone medical assessment with treating medical team (or review initial written medical report)
• Monitor on-going cases prioritising according to: medical need, local facilities, age of patient and cost of care and re-assesses at appropriate intervals
• Recognise potential cases at risk from deterioration and ensure appropriate measures are in place to manage ongoing care
• Notify duty doctor and Operations Manger of very ill, very young/old, pregnant and VIP patients or cases requiring high cost care in order that management of case may be escalated
• Ensure that cases requiring attention out of hours have been identified to Healix Medical Team and relevant notes have been forwarded
• Recognise when workload becomes unmanageable and effectively utilise available resources to ensure continuity of case management
• Utilise all resources available in order to establish accurately a patient’s medical condition and repatriation requirements
• Identify individuals that may have a relevant past medical history under the terms of their insurance policy and pre-travel medical declaration
• Understand the legal requirements of the Access To Medical Records Act 1988 and ensure that such requirements are adhered to at all times
• Provide repatriation advice taking into account the country of origin and local facilities, due date of return and likelihood of clinical deterioration, medical condition and requirements during travel, safest and most cost effective means of transport, airline medical clearance guidelines and Healix International repatriation guidelines
• Complete airline Medical Clearance (Medif) forms accurately and ensure appropriate assistance has been requested via the ticketing agent
• Provide Healix International repatriation team with sufficient medical information to ensure
  appropriate medical escort can be sourced
• Liaise with treating medical team overseas, to ensure ongoing care is maintained once patient has been repatriated, and ensure that any ICU admission is arranged in advance.
• Provide simple non-diagnostic medical or pre-money advice to an individual and refer to GP/relevant website when necessary.
• Provide UK hospital and specialist information to MAUK foreign correspondents
• Medically audit provider invoices when requested
• Act in a collaborative manner, yet demonstrate clear decision making skills in consultation with other members of the team
• Show awareness of the budgetary constraints of the role and work with team members and managers to ensure delivery of a cost effective service
• Act with autonomy within current professional guidelines and recognise own limitations, seeking advice and assistance where necessary
• Provide technical knowledge and support to assistance co-ordinators on medical matters

Telephone Support

• To provide telephone support on medical matters where required

Patient Support Programme (PSP) - to be implemented in 2009

• Patient Registration into PSP, registering Patient Data Consent form and Prescription
• Order prescription and appropriate dosage with the pharmacy
• Validate any payment & invoicing details with the PCT or budget holder
• Initial Outbound call to the patient to obtain patient history, disease severity in line with specific scripts
• Receiving Inbound calls from patients , carers and Health Care Professionals, all responses given are within pre-agreed boundaries as advised by pharmaceutical company
• Adverse Event reporting – reporting all patient adverse events to the pharmaceutical company
• ASAP within agreed procedures
• Scheduling and booking home nurse visits
• Scheduling of pharmacy drug dispensing and drug despatch with agreed partnering companies.
• Follow up call to patient and scheduling of next home visit. Collating feedback from home nurse
  network on the patient
• Attend training on the specific therapy area
• Despatch of additional support literature throughout the programme

Regulatory

• To work within and be compliant at all times with all relevant regulations and legislation applicable to the role. With particular reference to the requirements laid down under FSA and ISO criteria
• To ensure that all activities undertaken by the departments are conducted in line with regulations

Essential Skills & Attributes

• Registered general nurse (current registration with the NMC)
• Qualified for 5 years with a minimum of 3 years recent clinical experience in adult nursing.
• Grade RCN6/7 or equivalent
• Other nursing or work experience relevant to the post
• Ability to prioritise own workload and that of others
• Ability to work on own initiative
• Ability to motivate and lead the staff team and maintain good working relationships
• Evidence of ability to supervise junior staff and maintain good standards of care
• Proven teaching ability and experience of being an effective preceptor / facilitator
• An Understanding of the mechanisms employed for financial control and economy
• Demonstrates an understanding of and engagement with audit and quality issues (eg benchmarking)
• Advanced patient assessment skills
• Leadership
• IT Literate / keyboard skills
• Able to use own initiative & work both autonomously & as part of a team
• Excellent communication skills including non face to face
• Ability to prioritise and delegate
• Ability to identify own developmental needs
• Self motivated & ability to motivate & support others
• Problem solving
• Adaptable/Flexible
• Good attendance record
• Team player
• Ability to commit to ongoing mandatory training Open to change
• Well presented in line with working within a corporate environment

Desirable Skills & Attributes

• Additional professional qualification ENB 998 or equivalent Teaching / Training qualification or experience
• Experience of working within an A & E department of a hospital/intensive care unit
• Performance monitoring within a team
• Evidence of partnership working with key stakeholders
• Ability to demonstrate awareness of research based practice

How to apply

If you are interested in this role and would like to apply or require further information, please send your current CV and covering letter to recruitment@mondial-assistance.co.uk stating the reference MCM1008W as the subject of your email.