About The Role

The Specialist, Health Claims supports the financial operations of Carnival Corporation’s Health This role reports to the Manager, Crew Health and assists with supporting various population health, case management and seafarer health operations functions and is an integral part of the crew health team, providing logistical and administrative support.

They will help maintain necessary documentation with regarding the crew members case while also ensuring that communication of the progress of the case is done between the crew member, case management team, providers and other departments is in keeping with data privacy and security requirements. They will also respond to and direct communication from crew, case specialists, providers, and other departments in a timely fashion.

This role will interface with all brands, medical teams onboard, shoreside health services and public health leaders as well as external vendors that manage our healthcare systems. This includes supporting the Carnival Corporation's brands which comprises of eight brands with approximately 90+ ships carrying over 15 million guests annually and employing over 160,000 team members.

Essential Functions

Communication

Ensures timely distribution, categorization, prioritization and communication related to crew members medical cases such as unfit memos, crew member queries or concerns, return to work memos, approval communications to appropriate parties while following required privacy and security guidelines.
Address simple queries or concerns raised during the Case Management Process or the Seafarer Health process.

Documentation

Maintains accurate medical records from ships, providers, and crew for medically disembarked or referred crew members. Requests updates from crew members, providers, and vessels in a timely fashion, enters medical updates into databases, health records systems and distributes to appropriate case specialists while following privacy guidelines.
Update and load documentation related to crew members with regards to Seafarer Medicals or crew members who required return to work review.

Coordination

Works with the case specialists, internal and external teams to help coordinate administrative and logistical aspects of team members case such as transport and flights, lodging, appointments, and reimbursement.
Assist with Sick Wage Benefits administration tasks, such as creation of cases within Risk Management systems and data entry of crew members requiring sick wages
Review cases related to administrative tasks and action on the tasks in a timely manner

Audits, Workflow and Quality Improvement

Works with the Case Management Team and Seafarer Health Teams to help improve overall workflows by assisting with edits and changes to various systems that are used by the case management team such as Power Platforms. This may include making edits to formulas in Excel, PowerApps and modifications to user interfaces.
Collect and organize information for Quality Improvements Reports and Internal Audits.
Assist with Audits of Seafarer Medical facilities, including gathering documentation, scheduling audits and being present in Audits.

Administration

Assist the Seafarer Health Team, Case Management Specialists and Supervisors in administrative tasks that may be required for a specific case or project such as gathering and organization of information, data entry, categorization, creation of training data and communication with crew members.
Performs other duties as assigned

Knowledge, Skills & Abilities

Scope: The scope of this role is to provide support to crew case management and population health operations. The scope focuses around processing and management support of crew medical case management. Includes utilization of systems including electronic health record and internally developed tools utilizing PowerPlatforms.
Problem solving: The role requires knowledge of crew/ship logistics, effective communication, and general medical knowledge including compliance with HIPAA, and GDPR. The role requires collaboration with crew, shipboard medical centers, shoreside clinicians, and medical providers worldwide.
Impact: This role will contribute to the effective and efficient operations of crew case management with a focus on outcomes.
Leadership: This role does not have any direct reports, but will work with cross-functional teams and is expected to have strong project management and documentation skills and be a strong communicator.

For all roles

Knowledge: Understanding of workplace policies and procedures / Familiarity with team collaboration tools and techniques.
Skills: Strong time management and organizational skills
Abilities: Ability to maintain reliable and consistent attendance / Capacity to be punctual and meet deadlines / Ability to collaborate effectively with colleagues and work as part of a team / Demonstrated professionalism in all interactions and tasks.

Essential/Minimum qualifications

Associate degree or equivalent college coursework required. Bachelor’s degree is preferred. 1+ years of work experience with similar scope and responsibilities is required. College degree may substitute for work experience.
Proficiency in Microsoft Office and PowerPlatform. Familiarity with medical terminology

Essential experience required

Ability to apply analytical and logistic skills; maintain attention to detail and accuracy. Proficiency in the use of computer business applications with working knowledge of Word and Excel. Excellent interpersonal and communication skills (verbal and written) with providers, ship personnel, employees, internal departments, and management. Strong organizational skills and the ability to meet deadlines and handle multiple and competing priorities.

Travel : No or very little travel likely

Work Conditions: Work primarily in a climate-controlled environment with minimal safety/health hazard potential.

Physical Demands : Must be able to remain in a stationary position at a desk and/or computer for extended periods of time.

This position is classified as “in-office.” As an in-office role, it requires employees to work from a designated Carnival office in South Florida Monday through Thursday each week. Employees may work from their homes on Fridays. Candidates must be located in (or willing to relocate to) the Miami/Ft. Lauderdale area.

Offers to selected candidates will be made on a fair and equitable basis, taking into account specific job-related skills and experience.

At Carnival, your total rewards package is much more than your base salary. All non-sales roles participate in an annual cash bonus program, while sales roles have an incentive plan. Director and above roles may also be eligible to participate in Carnival’s discretionary equity incentive plan. Plus, Carnival provides comprehensive and innovative benefits to meet your needs, including:

Health Benefits:
Cost-effective medical, dental and vision plans
Employee Assistance Program and other mental health resources
Additional programs include company paid term life insurance and disability coverage
Financial Benefits:
401(k) plan that includes a company match
Employee Stock Purchase plan
Paid Time Off
Holidays – All full-time and part-time with benefits employees receive days off for 8 company-wide holidays, plus 2 additional floating holidays to be taken at the employee’s discretion.
Vacation Time – All full-time employees at the manager and below level start with 14 days/year; director and above level start with 19 days/year. Part-time with benefits employees receive time off based on the number of hours they work, with a minimum of 84 hours/year. All employees gain additional vacation time with further tenure.
Sick Time – All full-time employees receive 80 hours of sick time each year. Part-time with benefits employees receive time off based on the number of hours they work, with a minimum of 60 hours each year.
Other Benefits
Complementary stand-by cruises, employee discounts on confirmed cruises, plus special rates for family and friends
Personal and professional learning and development resources including tuition reimbursement
On-site Fitness center at our Miami campus

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