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LOCAL SUPPORT FROM CASE MANAGERS

4 October 2018

With 16 Cigna Case Managers around the world, our trained nurses take care of the medical aspect of clinical cases and remain in touch with the patient for a regular follow-up of their treatment. They guarantee the patient’s wellbeing and that of their family members.

Celiwe Mngomezulu, one of our Case Managers, tells us a bit about herself and how she supports staff members in South Africa.

Can you tell us a bit about your background?

I trained as a nurse and started my career working in psychiatry. After a few years I moved to the UK and worked in an Intensive Care Unit for 10 years. After that I returned to South Africa and worked as a Unit Manager in Intensive Care. I then decided to move to the corporate world. I worked at International SOS as a coordinating nurse before moving to Cigna in 2015 where I’ve been a Case Manager ever since.

How would you describe your role?

My role is really twofold, I care for our patients and I’m also Cigna’s local representative.

For the first part, I look after plan members with serious illnesses or who need intensive surgery. I personally visit patients who need to spend a long time in hospital, for example people who are undergoing chemotherapy. Besides practical support, I also provide moral support.

The patient is at the front and centre of everything I do. I’m there for them before, during and after hospitalisation. I guide them and explain how things will work. I give information about the treatment and possible side effects of medicines.

This is especially important with medical evacuations where the patient is in a new country. The health care situation in South Africa is really very specific. So, I explain how things work here and what they can expect, both from a medical and logistics point of view.

What many plan members don’t realise is that I can also support them before they need treatment. I can provide answers to any health-related concerns they may have.

As Cigna’s representative in South Africa, I negotiate with health care providers and make sure the offered treatments are appropriate and necessary. My goal is making sure the patient gets the best treatment.

What does an average workweek look like?

No two weeks are the same, so planning is essential. To plan my week, I check how many patients I’m currently looking after, how many patients are admitted and require visiting, which hospitals they’re in and if there are any issues with the providers that I may need to attend to while visiting them. I check if I have meetings scheduled with clients and providers as well.

I usually spend Mondays and Fridays in the office. On Monday, I follow-up on what happened during the weekend and I send the GOPs for the week. On Fridays, I make sure all loopholes are closed to avoid any issues for our patients over the weekend.

What do you enjoy most about being a Case Manager?

I love the personal interaction with patients, providers and HR contacts. It’s really great to be able to go through the whole journey with people. It’s very touching. The continued contact with previous patients is also very rewarding. I get to see how I made a difference in their lives.