Nurse Advisor (Hybrid)

Our client is looking to onboard a Nurse Advisor to provide medical case management support for emergency assistance cases in line with Medical Panel best practices and established clinical procedures. Review medical cases using the information received to ensure accurate, clear, and timely guidance is delivered to the Operations team and external medical escort providers.

Responsibilities

• Conduct medical triage by reviewing initial diagnoses and assessing patient requirements, including urgency, level of care, and location considerations
• Authorise medical investigations, treatments, surgeries, and hospital admissions in straightforward cases, including MRI and CT scans
• Provide guidance on the most appropriate treatment pathway in straightforward cases, considering insurance coverage, pre-existing conditions, and policy terms
• Escalate or refer cases to external clinical advisors when required
• Review and assess medical reports and updates received from healthcare providers
• Monitor patient progress throughout treatment to ensure appropriate standards of care and service quality are maintained, making decisions within scope and referring complex matters to medical professionals when necessary
• Support the coordination of medical evacuations and repatriations
• Identify and advise on potential policy breaches by requesting and reviewing past medical history and medical declarations where appropriate
• Review potentially fraudulent or excessive medical invoices to assess medical necessity, treatment appropriateness, and cost accuracy
• Ensure all medical information and case updates are accurately recorded within the case management system
• Maintain compliance with all applicable regulatory and confidentiality requirements, including patient data protection
• Support management in identifying and mitigating departmental risks
• Carry out all duties in accordance with company policies, acting with honesty and integrity, and reporting any suspected fraud or corruption
• Adhere to all company policies and procedures, including Health & Safety, Equal Opportunities, Data Protection, Code of Conduct, Security, IT, and Internal Financial Controls
• Undertake any additional duties or responsibilities reasonably assigned by management or the Company’s Senior Leadership Team

Requirements

• Must be a State Registered Nurse or Registered General Nurse
• Minimum of 3 years nursing experience, collaborating with medical doctors
• Good understanding of local and international regulations, including Treating Customers Fairly principles
• Capable of managing critical situations effectively while providing practical and straightforward solutions
• Sound judgement, decision-making, and problem-solving abilities are essential
• Ability to work both independently and collaboratively within a team environment
• Ability to identify issues quickly and determine the most appropriate course of action in line with departmental procedures and guidelines
• Excellent verbal & written communication skills in English, with a high level of accuracy and attention to detail

Benefits

• Hybrid
• Performance Bonus
• Health Insurance
• Company Discounts