Patient Advocacy Case Manager

1 week ago


Singapur, Singapore The Cigna Group Full time

Job Title: Clinical Care Coordinator

About The Cigna Group:

The Cigna Group is committed to enhancing health outcomes for individuals throughout their lives. Our mission is to provide guidance and support, enabling our clients to navigate the complexities of the healthcare landscape and make informed health decisions.

Key Responsibilities:

  • Oversee the pre-authorization process and claims by assessing proposed treatments for medical necessity and cost-effectiveness in accordance with established guidelines.
  • Identify and interpret relevant guidelines for managing intricate cases on both local and global scales.
  • Independently manage daily case management responsibilities while having access to senior team members for guidance.
  • Leverage clinical expertise to evaluate diagnoses and treatment strategies, pinpointing care gaps and potential risks.
  • Set patient-centered objectives and interventions, collaborating with the healthcare team and stakeholders.
  • Formulate comprehensive case management strategies that involve all relevant parties and foster effective communication.
  • Work alongside Cigna physicians to evaluate complex cases and implement clinical programs.
  • Ensure precise documentation and compliance with professional standards and policies.
  • Engage in training and professional development opportunities to enhance clinical knowledge.
  • Contribute to clinical initiatives and digital transformation projects.
  • Act as a clinical liaison to clients, balancing business objectives with patient advocacy.

Challenges and Adaptations:

  • Address emotionally charged and diverse situations with empathy and sensitivity.
  • Coordinate care for multicultural populations globally and collaborate with international case managers.
  • Ensure adherence to regulations and provide information to clients across various regions.

Value of the Role:

  • Acquire insights and experience within the insurance and healthcare sectors.
  • Cultivate leadership abilities and broaden understanding of business operations.
  • Apply healthcare expertise in a non-clinical environment while contributing to customer health and wellness.

Qualifications:

  • Bachelor’s degree in Nursing.
  • Clinical acumen to evaluate diagnoses and treatment plans.
  • Preferred familiarity with the Health Insurance sector.
  • Valid licenses and certifications in accordance with case management standards.

Essential Competencies:

  • Strong organizational and leadership skills.
  • Effective communication and interpersonal abilities.
  • Problem-solving and analytical skills.
  • Ability to build relationships with stakeholders, clients, and providers.
  • Advocate for clients while ensuring compliance.
  • Time management and prioritization capabilities.
  • Positive and proactive attitude.
  • Proficient in computer applications and office tools.


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