Case Manager (Clinical)

International SOS Singapore Pte Ltd; Singapore; Remote; SGD 60,000 - 90,000; Full time

Job summary

International SOS Singapore Pte Ltd seeks a TRICARE Case Manager to provide comprehensive case management for beneficiaries with chronic or high-cost conditions. You will assess needs, develop care plans, coordinate care, and monitor progress across a remote, multidisciplinary team.

The role requires an active nursing license, minimum 3 years of clinical nursing experience, and strong communication skills in English. Experience with managed care and TRICARE systems is a plus.

Qualifications

• Registered Nurse with active licensure.
• Minimum 3 years of clinical nursing experience.
• Strong clinical assessment and care coordination skills.
• Excellent written and verbal English communication.
• Ability to work independently and collaboratively in a remote, multidisciplinary team.
• Strong organizational skills and attention to detail.

Responsibilities

• Manage a caseload of beneficiaries enrolled in the TOP Case Management Program.
• Conduct telephonic outreach, assessments, and ongoing case management interventions.
• Develop individualized care plans and establish mutually agreed goals with beneficiaries.
• Provide disease education, medication support, and guidance on healthcare resources.
• Coordinate care with healthcare providers and multidisciplinary teams for appropriate treatment and continuity of care.
• Review medical treatment plans to support medical necessity and benefit review processes.
• Identify and facilitate referrals to appropriate healthcare services and providers.
• Monitor clinical progress, document case activities, and maintain records in the case management system.
• Participate in client presentations, audits, quality reviews, and performance monitoring.
• Support continuous improvement through trend analysis, reporting, and audits.
• Manage beneficiary concerns professionally and escalate complex issues as needed.

Skills

Registered Nurse

Clinical assessment

Care coordination

Communication skills

Independent work

Organizational skills

MS Office

Education

Nursing degree with licensure

Tools

Healthcare information systems

Job description

About the Role

As a TRICARE Case Manager, you will provide comprehensive case management support to beneficiaries with complex, chronic, or high-cost medical conditions. Working closely with beneficiaries, healthcare providers, TRICARE stakeholders, and internal medical teams, you will assess needs, coordinate care, develop care plans, and monitor progress to improve health outcomes and enhance the beneficiary experience.

This role combines clinical expertise, care coordination, advocacy, and stakeholder engagement to ensure beneficiaries receive appropriate, high-quality, and cost-effective care throughout their healthcare journey.

Key Responsibilities

• Manage a caseload of beneficiaries enrolled in the TOP Case Management Program.

• Conduct telephonic outreach, assessments, and ongoing case management interventions.

• Develop individualized care plans and establish mutually agreed goals with beneficiaries.

• Provide disease education, medication support, and guidance on available healthcare resources.

• Coordinate care with healthcare providers and multidisciplinary teams to ensure appropriate treatment and continuity of care.

• Review medical treatment plans and support medical necessity and benefit review processes.

• Identify and facilitate referrals to appropriate healthcare services and providers.

• Monitor clinical progress, document case activities, and maintain accurate records within the case management system.

• Participate in client presentations, audits, quality reviews, and performance monitoring activities.

• Support continuous improvement initiatives through trend analysis, reporting, and internal audits.

• Manage beneficiary concerns professionally and escalated complex issues when required.

Requirements

Essential

• Registered Nurse with an active nursing qualification and professional licensure.

• Minimum 3 years of clinical nursing experience.

• Strong clinical assessment, care coordination, and case management skills.

• Excellent written and verbal communication skills in English.

• Ability to work independently and collaboratively within a remote and multidisciplinary team environment.

• Strong organizational skills, attention to detail, and ability to manage multiple priorities.

• Proficiency in Microsoft Office and healthcare information systems.

Preferred

• Previous case management experience.

• Experience in managed care, healthcare insurance, medical assistance, or utilization management.

• Knowledge of the TRICARE Overseas Program or military healthcare systems.

• Experience working with complex, chronic, or high-cost patient populations.