Director, Medical Case Management

Great Vacations Begin With Great Employees!

Combine your experience and sense of adventure by joining our exciting team of employees in Miami, FL.  Royal Caribbean Cruises Ltd. is pleased to offer a competitive compensation & benefits package, and excellent career development opportunities, each offering unique ways to explore the world. 

Position Summary:

This Director of Medical Case Management will manage the medical care program for crewmembers on medical leave from the majority of the Royal Caribbean Cruises Ltd. (RCL) vessels. This position would oversee a team of approximately fifteen (15) members responsible for the case management of crew members receiving shore side care and/or on medical leave at locations around the world, including their home countries. The Director shall oversee cases for the quality of care, promptness, and management of company resources. Additionally, in collaboration with Medical Operations, the position will have the accountability to establish and build out a global network of care providers.

Career Snapshot:

• Directs a team of managers, and related case management teams, in the development and administration of the medical care programs to crew, who become ill/injured or are otherwise eligible for care.
• Provides oversight to include, but not limited to:
• Monitoring medical sign-offs for appropriateness and provides guidance on complex medical cases;
• Oversight of care plans to determine plan of administration and time when crew member is fit-for-duty/at maximum medical improvement;
• Interpreting medical records and collaborating with treating physicians to develop appropriate care plan for crew receiving shore side care or crew on medical leave;
• Insuring case managers are assisted with the correspondence to medical providers during case administration.
• Strategically aligns departmental resources and monitors the overall status of active cases to ensure quality of care, timeliness, and management of company resources. Utilizing clinical experience and independent medical judgment formulates, deploys, analyzes and continuously improves care plans, via case managers. Across crew medical, ensures the appropriate case reserves are on file for insurance purposes.
• Develops, analyzes and monitors metrics of crew medical statistics to determine trends, ensure quality of care, control costs, and identify other improvements/efficiencies.
• Establishes the protocol and is accountable for the proper documentation and completeness of case files for medical care provided by case managers, medical operations and other relevant providers. Monitors medical records of providers for quality, comprehensiveness and timeliness.
• Negotiate contracts/rates for medical services and monitor actual costs incurred for appropriateness. Be familiar with the companyu00bfs network rates and obtain adequate medical services within or close to said rates.
• Advises case managers and medical providers on legal, medical and ethical issues pertaining to Maritime laws/regulations, corporate requirements (RCL SQM) and effective risk management.
• Develops medical infrastructure (healthcare networks) for crew members/guests in ports of call, including travel, on-site inspections and negotiations, in collaboration with medical operations as needed.
• Collaborates in the investigation of suspected fraudulent crew medical claims.
• Provide litigation support in representing RCL in responding to and defending allegations related to the delivery of a crew care plan. Represent the company at depositions requiring testimony on same, as needed. Assist with deposition preparation for case managers who may be required to provide testimony on care plans provided to crew.
• Sourcing and development of subordinate managers and employee teams in areas such as policy, department procedures, and departmental or international regulations. Performance development and evaluation of staff. Identification and implementation of departmental processes and/or procedural change with an emphasis on assessing crew satisfaction associated with case management and support.
• Prepare presentations, reports and analyses for senior leadership and executives.

Requirements:

• Licensed Registered Nurse (RN) required; licensed physician [highly] preferred.
• Minimum of five (5) years of experience in a management position in hospital administration.
• Minimum of five (5) years of experience in crew wellness, occupational health, case management, medical assistance and/or workers compensation related fields.
• Three (3) plus years of experience in quality assurance, risk management and/or forensic nursing a plus
• Working knowledge of Jones Act and Maritime Maintenance and Cure issues preferred.
• Teaching experience in medical/nursing case review preferred.
• Ability to travel and maintain a flexible work schedule.

Additional Knowledege and Skills:

• Extensive knowledge of the quality and resources at medical facilities and providers as they relate to locations associated with the Brands collective itinerary.

• Clinical/medical background, managed care background, knowledge of medical networking and be able to provide information/support to legal personnel regarding the quality of care provided to crew members. Independent medical judgment and clinical knowledge and skills at a level to evaluate and discuss medical care provided to crew.

• Knowledge of legal and regulatory issues affecting the delivery of medical services to crew members.

• Knowledge base of services available in ports and home countries to determine best sites to recommend for care.

• Clinical knowledge base for common chronic illness in order to develop case management programs and assess management of medically disembarked and/or repatriated crew members.

• Proven leadership experience to oversee case managers and other team members.

• Excellent interpersonal skills to communicate and collaborate with all levels of management and employees.

• Excellent communication and presentation skills.

• Ability to read, comprehend and analyze complex documents/data and effectively present information to management, employees, and/or public groups.

• Working knowledge of Microsoft Office products, Lotus Notes, JD Edwards and claims management/electronic medical records systems.

Thank you for your interest in this role. Royal Caribbean Cruises Ltd. is the world's second largest cruise company, operating under Royal Caribbean International, Celebrity Cruises and Azamara Club Cruises brands. These brands offer an array of onboard activities, services and amenities, including simulated surfing, swimming pools, sun decks, beauty salons, exercise and spa facilities, ice skating rinks, in-line skating, basketball courts, rock climbing walls, miniature golf courses, gaming facilities, lounges, bars, Las Vegas-style entertainment, cinemas and Royal Promenades, which include interior shopping, dining and an entertainment boulevard.

Join our team as the Director of Medical Case Management.  Once you click to apply below, it will take you 10-15 mins to complete our application, which will help us better qualify your candidacy.   If you are being considered for this position you will hear back from us within the next < 30-60 > days.  During this time, you can view your application status on our career site. 

Join us at Royal Caribbean Cruises Ltd., where great vacations begin with great employees!

RCL is an Equal Employment Opportunity employer.