Job Description

Essential Job Duties and Responsibilities:

The Tokyo-based Coordinating Nurse is responsible for facilitating health care services requested under the health insurance policies of participating Japan-based US Federal Employee Health Benefit (FEHB) Program Carriers providing health insurance to US Government Civilians (Civs), working on behalf of the US Department of Defense.

MEDICAL ASSISTANCE SERVICES AND REFERRALS

• Receive and assess relevant medical related calls.
• Collect logistical, medical and collateral case histories pertaining to the medical event / incident to enable the patient’s referral to the most appropriate medical facility.
• Responsibility for medical due diligence and case direction with respect to requests for insurance coverage for medical treatment required.
• Be responsible for medical referral for patients to an appropriate level of care, clinical specialty and provider.
• Provide telephone medical assessment for patients and medically monitor the appropriateness of the treatment being administered by the treating medical facility.
• Collect relevant medical information to produce medical reports that effectively communicate medical progress and information to be utilised in determining whether treatment being administered, or that may be required, is provided for under the patient’s health insurance coverage.
• Effectively communicate verbally and/or in writing with the relevant parties on the progress of the patient and discuss appropriate medical management and dispositional recommendations.
• Be responsible for the medical information released by the Program team.
• Liaise with relevant Treating Medical Officers, Local Medical Officers and medical departments as appropriate to expedite case management and obtain information to determine whether the treatment is provided for under the patient’s medical insurance coverage.
• Positively promote the work of International SOS.
• Maintain high standards for detailed and accurate documentation including the consistent updating of case files adhering to robust principles of confidentiality.

CASE ESCALATION

• As per DOD Civilian Program escalation process to Local Medical Director.
• Escalation as per International SOS protocol to the Regional Medical Director or Medical Case Lead of individual Assistance Centres for possible complaint cases, unusual scenarios, and potential transport cases.

NETWORK SERVICES

• Collation of new information on medical providers and facilities encountered and the sharing of this information with Network Services
• Participate in site surveys (review of medical facilities), medical audits and provide written reports in accordance with the International SOS’ specification of the network audit tool.

Requirements

• Written and spoken Japanese (Fluent Level)
  Written and spoken English (Business Level)
• Experience of working in the acute care clinical setting, preferably ICU/ER for a period greater than 3 years.

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