A. Overall Purpose Of The Job (Brief description of the primary purpose of this position)
Delivery of professional and effective medical assistance services for TRICARE beneficiaries in compliance with TRICARE guidelines and TOP Contract specifications and expectations, maintaining International SOS highest standards of excellence within the Philadelphia assistance center.
B. Key Responsibilities (Critical responsibilities and skills of this position, listed in order of importance)
MEDICAL ASSISTANCE RESPONSIBILITIES
Responsibility for medical due diligence and case direction with respect to designated medical assistance cases on all TRICARE transmissions.
Responsibility for designated medically related tasks on all medical assistance cases and on all TRICARE transmissions.
Assessment of each designated case with respect to its medical elements and provide direction in order to facilitate medical due diligence and render the appropriate assistance.
Provision of assistance with referrals and retrospective claims assessments as may be requested.
Responsibility for ensuring that there is an appropriate medical handover of cases at the beginning/ end of each shift.
Provide medically-driven case direction during the daily morning transmission process.
Determine the frequency/intensity of medical contacts and communication with Treating Doctors, patients, family members and associated TRICARE personnel.
Assist with any referral and monitor the progress of medical hospitalization cases.
Provide medical input toward the planning and progress of operational issues relating to medical case management.
MEDICAL ASSISTANCE SERVICES (in the context of HIPAA)
Receive and assess medically related calls from beneficiaries, providers and TRICARE personnel. Obtain medical, logistical and pertinent information to the medical event/incident.
Provide medical input and advice via phone for designated patients in other parts of the world assess and monitor the appropriateness and progress of the treatment rendered locally, escalating to the Medical Director and Nurse Manager as deemed necessary.
Provide medical advice, within scope of practice, to TRICARE beneficiaries, relatives, and pertinent military personnel.
Organize and supervise medical assistance in keeping with the scope of services and contractual responsibilities. This includes obtaining medical reports, organizing referrals, monitoring patients’ conditions, recommending appropriate means of medical transportation.
Coordinate all aspects of medical transport when necessary – communicating with International Ops, AMA and providers as well as arranging receiving care and monitoring the progress of such patient movement.
Obtain medical reports from treating medical staff to determine the appropriateness of treatment, monitor medical care and arrange any patient’s transport requirements.
Assist in providing medical referrals in the regions covered and/or serviced by the Alarm Center.
Conduct intermittent site surveys of medical facilities within our region as may be requested by the Medical Director.
Assist in further development and enhancement of International SOS medical and logistical capabilities.
MEDICAL LIASON AND REPORTING (in the context of HIPAA)
Collect relevant medical information to produce focused and professional medical reports that effectively convey such information.
Professionally communicate verbally and in writing to the relevant parties on the progress of a patient’s condition. Discuss appropriate medical management and recommendations on final disposition.
Assume responsibility for the medical information released from the Alarm center.
Contact Treating Medical Officers and any other relevant medical personnel as may be required to expedite case management.
Liaise with other TRICARE medical personnel and any associated agency or contractor to effectively communicate medical and logistical information in accordance with specific needs.
Undertake public relations calls as required to ensure good communication and to promote clear and consistent understanding among patients, families, client personnel, etc.
Promote responsive liaison arrangements both within International SOS and externally. (i.e. medical representatives, patients and service providers).
Promote and present a positive image of the services rendered by International SOS.
Maintain high standards for detailed and accurate documentation including consistent case file updates.
Maintain the International SOS Medical Transportation Standards (MTS) in expediting all medical transportations.
Share direct responsibility for the assessment of medical and logistical aspects of evacuations and repatriations in conjunction with the rest of the medical team, Medical Director(s) and aviation department. This includes assessment for the necessity of an evacuation and the means by which it should take place. (i.e. air-ambulance / commercial carrier / seated / stretcher / escort type / medical equipment / etc.)
Liaise with airline medical departments for passenger medical clearance as may be required for any patient transport.
Act as a medical escort when required, appropriate and requested.
Determine most appropriate Medical escort personnel for the specific case in conjunction with the Medical Director and Aviation team.
Assist with the maintenance, upgrading and control of the emergency mobile medical equipment available in the alarm center.
GLOBAL ASSISTANCE NETWORK (GAN) AND REFERRALS
Assume responsibility for medical referrals such that patients can access adequate levels of care and the appropriate medical provider is selected.
Obtain new information on medical providers and facilities encountered and forward such to the Global Assistance Network (GAN) department with relevant medical commentary for further investigation.
Assist with site surveys, medical audits and write reports as per International SOS specifications upon request from the Regional Medical Director and in fulfillment of the International SOS Audit Tool.
Remain available to assist in the delivery of remote medical services as may be required by consensus agreement.
Escalation to the TRICARE Nurse Manager, TRICARE Medical Director, Regional Medical Director and Corporate Assistance Department (CAD), in that order respectively.
PROMOTION OF INTERNATIONAL SOS SERVICES
· Participate, under the direction of the Regional Medical Director and CEO, Americas and in consultation with the Marketing Manager, in appropriate business development activities to enhance International SOS activities.
· Assist in explaining International SOS medical services to prospective and existing clients as requested.
Work within and promote all International SOS policies and procedures.
Carry out other reasonable duties as requested by the TRICARE Medical Director and the Regional Medical Director.
Work flexible hours as appropriate to the needs of the position.
Undertake further training as requested to expand functional service delivery for other Corporate and Enhancement clients within the International Ops platform.
Undertake client specific training on unique software or involving program requirements to fulfill the expectation of the TRICARE contract and any other International SOS client as may be required
Maintain Continuing Professional Education. International SOS will endeavor to support appropriate Continuing Professional Education requests.
Play a leading role in case management and team development, working closely with the Operations Manager and Shift Supervisors.
· Attend supervision, training and departmental meetings when requested.
· Undertake accountability for your workload.
· Participate, when asked, in Coach2Win, Peer-Mentor, Training-Mentor, E-learning and like programs.
C. Job Profile
Required Skills and Knowledge (Brief description of technical knowledge or skills needed to perform the job)
· Proficiency in Word Documents, typing, communication skills
Required Work Experience (Brief description of the job-related experience needed to perform the job)
· Three to five years of recent inpatient clinical experience
· ICU and emergency medicine experience is preferred
Required Qualifications (Brief description of the educational background needed to perform the job)
· United States citizenship
· United States registered Nurse licensure (current)
· BCLS certification (current)
· ACLS certification (current)
Required Languages (Brief description of the language skills needed to perform the job)
· Bilingual in English and Spanish
Travel / Rotation Requirements (Brief description of any travel or rotation requirements)
· Opportunities for travel are available and optional
Internal Number: CN
About International SOS
The International SOS Group of Companies is the world’s leading medical and travel security risk services company. Present in over 1,000 locations in 90 countries, we are trusted by 11,000 organizations, including over half of the Fortune Global 500, multi-national corporate clients and mid-size enterprises, governments, educational institutions and NGOs to provide 24/7 support and assistance to their global workforces.
Our passion and expertise in helping others drive us to go the extra mile every day. Be it the front line or back office, your work is meaningful. Join us to make a difference today.
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