Requirements
The role requires a Bachelor's degree in Nursing, Health Sciences, Public Health, or a related healthcare field. Strong understanding of medical terminology and basic clinical pathways is essential, along with familiarity with healthcare authorization and service request processes. Proficiency in healthcare information systems and documentation tools is also required, along with excellent verbal and written communication skills and the ability to manage multiple cases with attention to detail.
Description
Job DescriptionTo guide members through their healthcare journey, ensuring they experience coordinated, clearly communicated care across clinical programmes. The role safeguards continuity between patients, providers and internal teams so that members navigate approved services smoothly and achieve better health outcomes.Patient & Case Care Act as the primary point of contact for members enrolled in clinical programmes, guiding them through approved care pathways, requirements and next steps. Coordinate internally to ensure timely processing and follow-up of healthcare service requests such as appointments, referrals and approvals, from initiation to completion. Follow up with relevant departments (medical approvals, provider network, customer service) to prevent delays and keep members informed within agreed service levels. Collaborate with healthcare providers, patients and their families to facilitate effective care management and improve health outcomes.Patient & Clinical Communication Provide clear, accurate explanations to members regarding their medical service requests, approvals and programme enrolment status. Translate medical terminology into patient-friendly language while maintaining clinical accuracy. Escalate complex clinical inquiries to appropriate clinical supervisors or physicians when required. Facilitate communication between patients and healthcare providers through Dedicated Care Teams to ensure continuity of care.Clinical Programmes Support Support the execution of clinical programmes by tracking patient milestones and adherence to assigned pathways. Monitor enrolment, follow-up schedules and required documentation. Assist in coordinating multidisciplinary interactions when required (e.g., providers, digital services, internal teams). Arrange necessary resources and services for patients, including referrals to specialists, community services and support programmes.Data Maintenance Maintain accurate, complete documentation of all member interactions, case notes and programme activities in internal systems. Ensure confidentiality and compliance with healthcare data protection regulations. Support supervisors with operational reporting such as caseload status and follow-up completion rates.Patient Experience & Service Address patient concerns related to care navigation within scope of authority. Identify recurring operational issues and escalate them to management. Contribute feedback to improve communication workflows and patient journey processes.SkillsStrong understanding of medical terminology and basic clinical pathways.Familiarity with healthcare authorisation and service request processes. Proficiency in healthcare information systems and documentation tools.Clear verbal and written communication skills.Ability to manage multiple cases simultaneously with attention to detail.EducationNursing, Health Sciences, Public Health, or related healthcare field