Case Manager, Crew Medical

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Position Summary:

The Crew Medical Case Manager is responsible for the management of medical care for crew who are medically disembarked in ports of call and/or are repatriated to their home country or designated medical center for medical care in compliance with applicable United States federal law (46 USCA Sec. 688 / Jones Act.).

The role provides direct oversight of medical care and services coordinated through appropriate medical providers, via collaboration with intermediaries, port and/or agents as needed, in assigned countries/regions, until the crewmember has been declared at maximum medical improvement (MMI). The case manager may collaborate with the ship medical team on decisions regarding care management plan for crew requiring extended medical treatment ashore. He/she follows company policies and procedures to ensure delivery of all crew medical care is provided promptly, properly, and adequately as required by applicable law. The case manager is also responsible for the documentation of all contacts with the crew member, family, providers and agents and the timely collection of all pertinent medical information including hospitalization and office notes, labwork, diagnostic tests, therapies, medications, etc. He/she will maintain the privacy of all Protected Health Information (PHI) in compliance with applicable HIPAA and GDPR regulations. The case manager will ensure that any crew member who is determined to be at MMI may return to work where applicable in support of the operational needs of his/her department. This decision can be made independently, through consultation with management, or by committee decision for more involved cases.

• Plans, evaluates, and facilitates crew medical care and benefits via local port/country agents, intermediaries or designated medical providers in assigned countries/regions until crewmember is declared at maximum medical improvement (MMI).
• Maintains documentation on case status regularly in Riskonnect System.
• Communicates with crewmember regarding medical benefits and treatment plan at least biweekly, or as deemed by the severity stratification.
• Calculates and updates financial reserves for each assigned case at least monthly and with any significant treatment plan or new diagnosis. Exercises independent judgment and discretion to identify high exposure/significant medical cases expected to exceed applicable deductibles and thereby necessitating applicable P&I Club notification.
• Collaborates with and supports crew in port and/or repatriated to determine appropriate treatment location for medical disembarkation. Decision should take into consideration the patient's medical condition, patient transport tolerance, available medical equipment, supplies, medications, and medical expertise at receiving facility. Arranges second medical opinions as necessary.
• Communicates with crew to ensure understanding of benefits and risks associated with complex surgical procedures, treatment plans and medications. Facilitates communications with crew member's emergency contact/family to advise of medical status and company's actions to provide care or efforts in repatriation of remains in case of crew member's death abroad.
• Participates in case review meetings of active medical and/or litigated cases. Prepares reports on active cases.
• Identifies and prepares cases for direct settlement review in conjunction with Legal team.
• Collaborates with Legal team in the transferring of cases that become represented, in identification and preparation of case reviews for potential settlement/buyout. Participates in pre-deposition/pre-trial conferences where applicable.
• Supports Legal department through participation at depositions and/or trials as company representative as required. Keeps current on availability of medical resources in assigned countries/regions commensurate with new developments in medical industry.
• Exercises independent judgment and/or collaborates with Network team in the negotiation of most favorable rates for quality medical services worldwide.
• Liaises with CareTeam members on crew medical disembarks, deaths or other serious illness/injuries. Organizes medical escorts and/or air ambulance evacuations worldwide.
• Performs other duties as required. This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.

• Bachelor's degree or equivalent experience in health care or case management required.
• Minimum of three (3) years case management experience in handling Maritime/Jones Act and/or personal injury cases.
• Ability to work flexible work schedules and occasional weekend days to support fleet and department as assigned and/or required. Work shift changes may be required based on business necessity (high season/itinerary changes and time zone).
• Registered Nurse (RN) highly preferred.

• Strong independent decision-making ability regarding care management plan for ill/injured crew based on merits of each case and review of all medical records and treating physician recommendations.
• Excellent communication skills both written and verbal. Ability to read, analyze and interpret business/professional documents.
• Able to effectively summarize complex and at times, voluminous medical records.
• Bi-Lingual preferred but not required. (i.e., Spanish, Tagalog)
• Understanding of medical terminology
• Detail oriented
• Ability to perform basic math, compute, calculate, percent and to interpret bar graphs.
• Computer Skills required: Microsoft Office, Lotus Notes, PeopleSoft. Will need to learn Riskonnect and SeaCare for the management of cases.