Manager, Case Management & Clinical Operations (Philippines)

Cruise Administration Services Inc. (CASI), a Carnival Cruise Line entity in the Philippines currently has a Manager, Case Management & Clinical Operations role available. Only candidates located in the Philippines to apply.

Job Summary:

This role reports to the Senior Manager of Case Management and oversees the daily operations of crew case management. The Manager leads a team of specialists to ensure timely, empathetic communication and resolution of high-complexity cases involving clinical, legal, and logistical challenges.

Key responsibilities include reviewing care plans, coordinating with internal stakeholders, supporting disability claims, and facilitating return-to-work planning. The Manager also escalates high-risk cases, conducts utilization reviews, and represents the company in arbitration when needed.

Operationally, the role supports shipboard medical teams, participates in the 24/7 duty rotation, and manages onboard referrals and disembarkations. The Manager monitors performance metrics, drives continuous improvement, and leads the development of the crew health programs, and policy development.

This position requires strong knowledge of cruise ship medicine, maritime regulations, and crew health standards, and involves collaboration across brands, medical teams, and external providers.

Carnival Corporation is comprised of eight brands with approximately 95 ships carrying over 14 million guests annually and employing over 160,000 crew members. 

Essential Functions:

Case Management Oversight

·Manage high-complexity cases involving clinical challenges, cases in port, legal and regulatory risks, and logistical constraints. 
·Coordinate and communicate with medical providers, legal, HR, and case management teams to ensure appropriate, timely care delivery. 
·Communicate with seafarers and their families with professionalism and empathy. 
·Review clinical care plans for appropriateness and support the case management team in decision-making. 
·Oversee care coordination for referred and disembarked crew, ensuring adherence to evidence-based and cost-effective practices. 
·Facilitate crew return-to-work planning in compliance with regulations and employment obligations. 
·Support disability claims and benefits review for crew unable to return to duty. 
·Collaborate with the crew health team to assess fitness for duty per International Maritime Health standards.

Crew Medical Claims Management

·Escalate high-risk crew cases to risk management, legal, HR, and clinical governance teams. 
·Review crew claims for relevance and appropriateness in coordination with internal and external legal teams. 
·Represent the corporation in arbitration proceedings related to crew medical cases. 
·Lead investigations into complaints or concerns regarding crew medical issues. 
·Conduct utilization reviews to assess medical necessity and customary costs and contribute to documentation accuracy. 
·Identify areas of improvement with healthcare providers and assistance companies and work with necessary stakeholders to build relationships, improve workflows and grow healthcare networks. 

Operational Support

·Provide logistical and clinical support to shipboard medical teams, especially for complex cases. 
·Work with the Health Operations Center to serve as a resource and for medical emergencies, medevacs, public health concerns, and other critical crew health issues. 
·Coordinate onboard care referrals and disembarkation processes. 
·Participate in the 24/7 duty schedule for crew medical support.
·Support the Senior Manager of Case Management in developing and maintaining policies and procedures for crew health and case management. 
·Conduct quality assurance and patient satisfaction audits to ensure compliance and continuous improvement.

Team Management

·Coach and performance manage the case management team to meet or exceed productivity and quality goals. 
·Establish and promote best practices and workflows for case management, including coordination with assistance companies. 
·Collaborate with internal departments to ensure aligned and well-coordinated health initiatives. 
·Monitor key performance indicators, population health data and produce recurring reports on case management metrics. 

Crew Health Programs

·Identify illness trends and lead the development of preventative and screening health programs based on medical evidence. 
·Train and work with shipboard and shoreside medical teams to implement and monitor effects of health programs.

Qualifications:

•  Must have a medical background with knowledge in occupational health, family practice, legal policies, and procedures. 
• Ability to apply analytical and logistic skills; maintain attention to detail and accuracy. 
• Minimum 3 years supervisory experience and 7 or more years in clinical or related administration position. Preferred to have at least 2 years of clinical practice on cruise ships. 

• Amenable to work daily onsite in Pasay City, Manila

  
  

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