Case Mgr, Crew Medical

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).

Essential Duties And Responsibilities

• 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.
• Decides on appropriate treatment location for medical disembarkation considering the patient’s medical condition, transport tolerance, available medical resources, 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.
• 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.

Qualifications, Knowledge And Skills

• 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.
• 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.
• Able 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).
• 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.