Global Case Manager Jobs

Global Case Manager

Hong Kong - Kowloon

Hybrid working (up to 3 days working from home)

Permanent

Full time – 38.75 per week

Here you’ll be welcomed. We champion diversity and we understand the importance of our people representing the communities and customers we serve. You’ll find an inclusive environment where you can be yourself and where everyone is driven by the same purpose – helping people live longer, healthier, happier lives and making a better world.

Bupa Global is the international health insurance division of Bupa. We provide customers who want premium international coverage with products and services to access the healthcare they need anytime, around the world, whether at home or when studying, living, travelling or working abroad.

Bupa Global has offices around the world including London and Brighton (UK), Dublin (Europe), Miami (USA), Dubai (UAE, in partnership with OIC), Egypt and Hong Kong (China) as well as regional offices in mainland China, Singapore, the Dominican Republic, Bolivia, Panama, Guatemala and Ecuador.

Role Overview

The primary goal is to evaluate and authorise clinical cases and complex medical preauthorisation and support our members during their treatment journey.

What You’ll Do

• Input clinical information into computer database, under the supervision of regional case manager
• Proactively identify fraud and/or abuse and reports to appropriate parties
• To investigate, and response to enquiries for complex medical pre-authorization and high value claims from different internal and external shake holders including but not limited to members, providers, service providers and intermediaries in the appropriate method, in line with Bupa Global policy and management style
• Proactively negotiate medical cost based on evidences to achieve either reduced cost to the business
• Identify opportunities to reduce future claim expense for Bupa Global
• Oversee member’s progress and monitor the discharge plan drafted.
• Assist Regional Contracting Manager with projects in ad-hoc basis.
• Ensure the correct interpretation of Bupa Global’s policies and rules, using the appropriate coding system to process the data and information accurately.
• Prepare documents and reports required for internal and external shake holders in the scope of case coordination activities and/ or data collections.

What You’ll Bring

• Excellent interpersonal skills and ability to work with a team is a must
• Excellent knowledge of Microsoft Word and Microsoft Excel is a must.
• Excellent analytical and critical thinking skills
• Understand the business commitment to meet deadline and turn-around time
• Proficient communication skills in English
• At least 2 years of solid experience in utilization review or case management in IPMI environment.
• Highly customer focussed and able to place customer’s health and benefit in the first priority.
• Knowledge of coding system is a must
• Doctor or RN experience with speciality (local or overseas) is preferred. OR
• Fluency in Cantonese also highly desirable
• Respects diversity and embraces cultural difference

Why Bupa?

We are a health insurer and provider. With no shareholders, our customers are our focus. We reinvest profits into providing more and better healthcare for the benefit of current and future customers.

Diversity and Inclusion

Bupa is committed to making sure that every applicant is assessed solely on personal merit and qualifications. We actively celebrate the diversity of our colleagues and provide an inclusive environment so you can bring your true self to Bupa. We’ll make sure you are treated fairly. That’s why we’re happy to offer reasonable adjustments as part of our recruitment process to anyone that needs them.

Whether you’ve found your feet or are discovering a new path.

Welcome to a place that celebrates you.

This isn’t where you've been.

This is where you're going.

This is what we have belief in.

Time Type

Full time