Clinical Case Manager - north york (Toronto)

At MSH, passion meets profession. We are a team of dedicated enthusiasts looking for a Clinical Case Manager who thrives in high-stakes environments.

What You’ll Be Doing

• Clinical Expertise & Validation
  • Medical Oversight: Perform medical reviews to validate the necessity and eligibility of services for a diverse global caseload.
  • Expert Opinion: Provide guidance on medical necessity, length of stay, and reasonable and customary charges for international medical services.
  • High-Value Claims: Review and release high-dollar claims, establishing reserves and ensuring appropriate follow-up.
• Global Coordination
  • Repatriation: Facilitate complex commercial or medevac repatriations, ensuring patients get home safely.
  • Stakeholder Liaison: Act as the primary clinical contact for Case Managers, Intake Specialists, and Claims Examiners.
  • Reporting: Summarize medical data into clear, concis...