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Healthcare Plan Case Manager
2 months ago
We are seeking a skilled Clinical Case Manager to join our team at Health and Care Management Ltd. As a key member of our healthcare team, you will play a vital role in ensuring our members receive the best possible support and care.
The ideal candidate will have experience working in an insurance or claims environment, with a strong understanding of clinical and non-clinical pathways. You will be responsible for establishing the current reason for ill health/injury and identifying any underlying causes or contributory factors.
Key Responsibilities:
- Support the multidisciplinary assessment process by providing thorough and accurate information to assess personal and occupational risk factors.
- Advise members on the reason(s) and multifactorial issues associated with their current episode of ill health/injury and how they can take control of mitigating these.
- Follow managed care pathways, NICE and other evidence-based clinical guidelines.
- Review private and NHS treatment options when making onward referrals for consultations, investigations, and treatment.
- Source appropriate treatment providers, in line with the rules and benefits of our health insurance plans.
- Keep up to date with the latest rules and benefits of each plan offered by our Corporate Customers, including changes, amendments, and exceptions.
- Work seamlessly with our onsite Functional Health team to manage referrals and provide three-dimensional service.
The successful candidate will possess:
- Proficient Microsoft Office skills and confidence using IT systems in general.
- Excellent communication skills, both telephonically and in written communications.
- An investigatory and problem-solving mindset.
- Ability to manage workloads effectively to deliver against customer service deadlines and expectations.
- Essential experience working in an insurance or claims environment, with a strong understanding of clinical and non-clinical pathways.
- 25 days annual leave.
- Your birthday off.
- 6% company pension contribution.
- Bike to Work Scheme.
- Medicash Health plan.
- Enhanced Maternity/Paternity/Adoption and Shared Parental leave.
- 2 voluntary days per year.
- Long Service Awards.
- Employee Wellbeing Seminars.
- CPD opportunities.
- Professional memberships paid for (role dependent).
