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WTP - Medical Case Manager

95149

 

World Travel Protection Canada Inc. (WTP- a division of Zurich Canada Holdings) is a unique and specialised service provider with over 25 years of diverse industry experience including emergency medical, travel security, travel assistance services and solutions to clients all over the globe. We offer emergency assistance services 24/7/365 with highly trained personnel including medically qualified staff (doctors & nurses) and medical case management as well as logistics specialists. WTP provides full spectrum of Third Party Administration (TPA) services including claims management for the travel insurance industry. Over the years WTP has earned the reputation of a quality service provider. Thus, the name WTP has become synonymous with quality and dependability. 

 

As a global assistance organization, we all belong to one global group with a shared goal of looking after our customers—their dreams, aspirations and the memories they are yet to make. We want to attract and retain talent that appreciates and can contribute to this aspiration. This is based on our core values of Optimism, Caring, Reliability, Determination and Togetherness. Throughout the pandemic that has impacted so many lives and industries, it has never been more clear that success through these core values is part of our DNA. If you share this type of outlook, perhaps you may find a good fit here at World Travel Protection.

At present we are looking for a Medical Case Manager to join our team at the Toronto Office (901 King Street West, Intersection - King Street & Strachan Avenue). The successful candidate should have relevant clinical experience founded upon sound medical knowledge, be customer oriented and able to take critical decisions within narrow time frames. We welcome applications from all prospective candidates who strongly believe that they have the desired skills & qualifications, and are equally passionate about serving our clients and customers.

 

JOB SUMMARY

 

A Medical Case Manager (MCM) provides clinical expertise to support emergency medical assistance services to customers travelling around the world. They collaborate with multiple stakeholders, including but not limited to; healthcare providers, underwriters and special vendors to ensure the overall management of a medical claim is in accordance with the terms & conditions of the insurance policy. A MCM coordinates the care plan in a manner that mitigates health risks as well as financial risks, and strategizes to contain costs without compromising quality of care. The overall objective is to provide outstanding services to our clients and customers, in alignment with company values, vision & mission, and in compliance with necessary regulatory obligations.

 

 

Job Qualifications

 

Preferred:

 

Registered Nurse in good standing with the College of Nurses of Ontario (copy of license to be provided annually).

 

Desired Skills and Experience:

 

At least 3 years of hospital experience in a clinical role
Desirable Clinical Experience: Emergency Medicine & Trauma, Critical Care Medicine, Cardiology, Neurology, Orthopaedics, Surgery
Excellent communication skills (both written and verbal):
ability to communicate at all levels with clarity and precision
ability to liaise with multiple stakeholders and build consensus
Proficient in computer systems and applications including MS office
Ability to meet tight timelines under pressure while delivering quality service
Display high energy, passion and a positive attitude
Own the results and willingly seek and accept personal accountability
Seek opportunities to continuously learn about new products, policies and client priorities and their expectations
Assign a high priority to customer service excellence and understand the value of customer satisfaction in driving success
Be flexible and personally embrace change


Unique Requirements:

 

Accurate data entry skills including reasonable typing speed
Flexible to work in shifts (night shifts if business needs require) and willing to be available for on-call duties (after-hours) as per business needs
Assets:

Fluent in additional languages, particularly French or Spanish
Training/knowledge of Aerospace Medicine and Flight Physiology
Knowledge of privacy acts: PIPEDA and HIPAA
Previous Case Management experience
Case Management certification, CRRN, CDMS, CCM or CRC
Experience in travel insurance industry and/or managed care
Experience in healthcare system of the United States & Canada

Job Accountabilities - Key Accountabilities


• Ensure customer satisfaction by making contact with the client, medical provider and claim professional in a timely manner and according to Best Practices.
• Ensure customer service by proactively communicating information; responding to inquiries; and following customer specific protocols.
• Establish a case management plan by completing evaluation and recommend plan of action.
• Coordinate and communicate activities of the case management plan by maintaining ongoing communication with client, provider(s), and claim professional as appropriate and according to Best Practices.
• Manage activities associated with case by completing assignments from claims staff, utilizing Managed Care tools (Preferred Provider Organizations, preferred vendors), addressing issues and escalating as appropriate.
• Document information according to Best Practices (including case assessment, case management plan, follow-up communication, closure, billing, cost containment and return to work data).
• Meet quality standards by following best practices.
• Manage appropriate case load according to policy and ensure accurate billing of all case management activity.
• Ensure legal compliance by following state and federal laws and regulations and internal control requirements.
• Acts as a technical resources by participating in presentations and provide education/ training sessions as needed, and/ or as requested by Manager.
• Maintain professional and technical knowledge by participating in educational opportunities, staying current with industry trends, establishing personal networks, and participating in professional societies.
• Contribute to the team effort by accomplishing related results and participating on projects as needed.
• Protect Zurich’s reputation by keeping claims information confidential.
• Maintain professional and technical knowledge by participating in educational opportunities, staying current with industry trends, establishing personal networks, and participating in professional societies.
• Contribute to the team effort by accomplishing related results and participating on projects as needed.

 

 

A future with Zurich

 

Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 148 years of experience managing risk and supporting resilience. We are a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. Today, we serve more than 25 industries, from agriculture to technology and insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, Zurich strives to provide ongoing career development opportunities and foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our people, our customers and the communities we serve.

 

As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers’ expectations. Zurich is committed to providing a diverse, inclusive and barrier-free environment resulting in an accessible organization for employees, customers, and other parties who interact with, or on behalf of, Zurich. We strive to achieve a workplace free of discrimination of all forms, including discrimination on the basis of physical or mental disability, or medical condition. If you are interested in a job opportunity, please advise if you require an accommodation, so we can work with you to provide a more accessible process. 

 

Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich Canadian Holdings Limited. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission.