TRICARE Coordinating Nurse

About the role

International SOS provides comprehensive healthcare management to beneficiaries enrolled in the TRICARE Overseas Program (TOP).

This role will require close interface and regular communication with TRICARE, our client, and with their beneficiaries who are enrolled in each region. The TRICARE Nurse will be responsible for the delivery of professional and effective medical assistance services for TRICARE beneficiaries in compliance with TRICARE guidelines and TOP Contract specifications and expectations, maintaining International SOS highest standards of excellence within the respective contact centres.

Key responsibilities

The TRICARE Nurse will work closely with the TOP Medical team, such as the Near Patient Team (NPT) where applicable, and with the TOP Operations team.  Through robust medical oversight, medical monitoring and reporting on beneficiaries enrolled with the TRICARE programme, the TRICARE Nurse has the following responsibilities:

• Triage beneficiaries to assess and direct the standards of care they require
• Undertake policy reviews for requested healthcare services, issue authorisations and denials
• Perform assessments on standards of care tailored to each specific location and medical situation, utilizing all available resources
• Provide comprehensive medical advice and recommendations according to each individual medical situation
• Medically monitor beneficiaries for the duration of admission to a healthcare provider
• Communicate with healthcare providers and medical professionals in the region to assess international standards of care being provided to beneficiaries
• Prepare, report and verbally communicate medical information regarding beneficiary clinical status to the client in a confidential and time bound manner.
• Interact with operations and logistical team coordinators to ensure optimal quality case management and service delivery.

About you

• Registered General Nurse Active Registration/License
• BCLS certification
• Experience in acute care (ICU/ED) and/or primary care, Medical/Surgical, Maritime medical experience,
• Previous telephone triage experience desirable
• Previous experience in Clinical Case Management desirable, not essential
• Broad medical knowledge with clinical experience and critical thinking skillset
• Computer literacy skills with experience in Word, Outlook Excel and Adobe (PDF)
• Excellent customer service skills.
• Excellent written and oral English Language
• Additional language skills desirable, not essential

Benefits