Medical Case Manager


QA Employment Consultant

Medical Case Manager


  • Take initial calls from policyholders in relation to medical claims or enquiries:
    • Establish the purpose of the call and determine the salient points in a timely fashion without exploring unnecessary avenues
    • Establish whether the caller has a valid policy in place using all available resources
    • Document the facts of the case on the Case Management System (CMS)
    • Provide advice on the documentation required to proceed with a claim
  • Provide clinical leadership and guidance to the team to ensure members receive timely and accurate cover decisions, allowing them to progress with their treatment.
  • Arrange care with an appropriate medical team/medical facility utilizing company network providers wherever possible
  • Assess any proposed treatment plans for medical necessity and to ensure they fall within policy terms and conditions
  • Ensure that treatment delivered is appropriate at all times by monitoring ongoing treatment plans and medical updates for individuals.
  • Monitor patient progress and liaise with the provider to ensure the member is discharged to an appropriate environment.
  • Liaising with treating medical staff, providers and with medical staff in order to manage cases efficiently and ensure the very best care plan is established for patients.
  • Maintain accurate case records on the CMS system to include details of care delivered and all related communication.
  • Make sure that treatment received and delivered meets policy requirements and standardization.
  • Communicate effectively with all parties providing relevant information to:
    • Clients and treating medical team
    • Members of the team
    • Patients and their families.
  • Ensure that costs remain routine and customary for the care delivered.
  • Medically audit provider invoices where necessary.


  • Preferred to have at least 5 years of nursing experience, with at least 1 year in A&E Department
  • Can do call centre duties
  • Can access the patient’s condition on the first level
  • Able to communicate fluently with Japanese callers


Interested applicants please send your resume to or call 6337 7449 for more information

(Wong Yen Yong Christine, EA Registration No: R1101725)

To apply for this job please visit

Contact Us

We're not around right now. But you can send us an email and we'll get back to you, asap.

Not readable? Change text. captcha txt