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The Medical Coordinator is responsible for providing expert clinical advice and assistance to the traveler and Europ Assistance Business in relation to proactive case management and claim liability decisions.
The clinical SME supports Assistance, Claims and Complaints to ensure medical care is timely, appropriate and the risks for both the traveler and business are managed in line with our Operational processes and procedures. These are monitored and managed by the Clinical, Operational and Risk Management Framework.
KEY RESPONSIBILITIES
Clinical Support
* Verify travellers are receiving appropriate and necessary treatment using MNA and current medical reports
* Identify the clinical risk and/or deterioration of a traveller and escalate to the Medical Doctor for case direction.
* Provide clinical support and advice to travellers and the Travel Business in relation to policy benefits and exclusions
* Liaise with treating medical teams and global providers to obtain supporting clinical information.
* Oversee medical repatriations/evacuations to ensure timely movement of travellers
* Support with facilitating accepting medical care in travellers' receiving hospital
* Conducting fitness to fly and functional nursing assessments in line with airline requirements and EA procedures
* Interpret and action medical and travel documents for effective Clinical Case Management and Claims Liability advice.
* Apply the knowledge of product benefits and exclusions in the context of clinical history, to provide Travel Claims recommendations on liability.
* Holistically consider financial, medical and logistical elements of cases ensuring optimal care outcomes, value and experience.
* Effectively manage caseloads and ensure operational efficiency.
* Communicate and utilise systems to ensure effective and timely case management.
* Identify and comply with escalation and risk management procedures.
* Promote a traveller centric culture within the team and set high standards of service
* As an SME drive projects to improve traveller experiences and business outcomes
* Provide clinical expertise to Customer Relations Team in relation to clinical case/claim escalations
* Ensure our EA C.A.R.E ethos is infused into every aspect of service delivery
* Adherence to EA Global Practices such as SAFETY, ALERT and other programs aligned to Medical Assistance in Travel
Maintain Professional Registration and Clinical Currency
* Maintain Clinical Currency through ongoing clinical practice, education and training
* As per the Group Clinical Quality Assurance Framework you will participate in Clinical Audits to ensure cases are managed timely, recommendations are consistent and appropriate and case outcomes recorded
* Identify and provide solutions to areas of improvement
* Understand and interpret EA's strategy and its requirements.
* Provide clinical support across all teams to ensure positive solutions for employees and travellers
* Maintain good working relationships with providers, and ensure feedback loops are well maintained
* Attend Clinical Up-skilling relevant to role. This can include Basic Life Support, aeromedical training to ensure clinical competencies/certificates fulfilled for CPD (Continuing Professional Development)
WHS Responsibility
* Utilise flexible work arrangements to promote a healthy work/life balance
* Ensure reasonable care for own health and safety as well as the safety of others at the place of work.
* Report and escalate concerns of work related behavioural, physical and/or mental health concerns
* Understand and comply with EA's company policies, including but not limited to Health & Safety, Code of Conduct, Security, and Data Protection
* Ensure risks relevant to your role are identified, assessed, managed and monitored in accordance with the EA Group Risk Management Strategy and Compliance Management Framework.
* Consistently demonstrate the required Risk Management Capabilities, outlined in our KPIs document
ROLE REQUIREMENTS
* Active AHPRA-registered nurse (or international equivalent) with experience >5 years, across a range of clinical settings including but not limited to: Emergency Medicine, Intensive Care Nursing, Aviation Medicine, remote medicine, tele-medicine
* Strong analytical and problem-solving skills
* Experienced in stakeholder engagement and high-level communication
* Experience in handling highly emotive situations in a calm and professional manner
* Strong organisational skills and ability to prioritise under pressure
* Demonstrated understanding of efficient case management to minimise costs and mitigate financial leakage
* Strong written and verbal English skills
* Experience in Travel Insurance Industry and Emergency Assistance Medicine
Seniority level
* Seniority level
Associate
Employment type
* Employment type
Full-time
Job function
* Job function
Other
* Industries
Insurance
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