Clinical Case Management Nurse - US Healthcare

Company:

Marsh

Description:

We are excited to welcome a Registered Nurse Consultant to our growing team in the Philippines!

As a Registered Nurse Consultant, you will make an impact on patient outcomes by providing clinical guidance to benefit administrators, identifying opportunities to improve care coordination and case management, and supporting the implementation of action plans that promote effective clinical management.

This is an exciting opportunity to bring your clinical expertise beyond traditional nursing practice, collaborate with US healthcare partners, and contribute to improving healthcare management and clinical outcomes.

This is a hybrid role based in the Philippines, with a requirement to work at least three days per week in the office.

We will count on you to:

• Establish effective carrier/vendor relationships with assigned book of business to successfully represent Mercer and to serve our clients.
• Communicate Mercer's point of view on effective clinical management program models and strategies to manage potential and actual high-cost claimants.
• Bring a natural curiosity and continuous quality improvement mindset to evolve and enhance the clinical strategy and delivery of assigned book of business.
• Interpret claims and other data reports leveraging this information to effectively manage assigned book of business.
• Lead case discussions with the benefit administrators’ clinical teams to identify strengths and opportunities in how the case is being managed and offer suggestions to shape the course of the member’s care moving forward.
• Synthesize available data, develop engaging reports / presentations, effectively present results to clients in a clear and constructive manner using formats that allow for tracking results over-time to support continuous process improvement.

What you need to have:

• Associate or Bachelor’s degree in Nursing required, with an active, unrestricted U.S. RN or Philippine RN license.
• Minimum of 5 years of relevant work experience in case management, clinical consulting, clinical carrier related experiences (quality assurance, clinical auditing, clinical leadership, stop loss).
• Proven project management, verbal and written skills with strong clinical acumen.
• Ability to analyze clinical data and metrics.

What makes you stand out:

• Master’s level degree in related field preferred.
• Case manager certification.
• Prior experience performing clinical program assessments or working with stop loss cases.

Why join our team:

• We help you be your best through professional development opportunities, interesting work and supportive leaders.
•  We foster a vibrant and inclusive culture where you can work with talented colleagues to create new solutions and have impact for colleagues, clients and communities.
• Our scale enables us to provide a range of career opportunities, as well as benefits and rewards to enhance your well-being.

Marsh (NYSE: MRSH) is a global leader in risk, reinsurance and capital, people and investments, and management consulting, advising clients in 130 countries. With annual revenue of over $27 billion and more than 95,000 colleagues, Marsh helps build the confidence to thrive through the power of perspective. For more information, visit marsh.com, or follow us on LinkedIn and X.Marsh is committed to providing an inclusive work environment. We aim to attract and retain the best, most qualified people and value colleagues of all backgrounds, without regard to age, background, disability, ethnic origin, family duties, gender orientation or expression, marital status, nationality, parental status, personal or social status, political affiliation, race, religion and beliefs, sex/gender, sexual orientation or expression, skin color, or any other characteristic protected by applicable law.Marsh is committed to hybrid work, which includes the flexibility of working remotely and the collaboration, connections and professional development benefits of working together in the office. All Marsh colleagues are expected to be in their local office or working onsite with clients at least three days per week. Office-based teams will identify at least one “anchor day” per week on which their full team will be together in person.