Clinical Excellence Specialist
4 days ago
We are seeking a skilled Clinical Excellence Specialist to join our team at WPA Health Insurance. As a key member of our Clinical Excellence team, you will play a critical role in providing exceptional support to our customers who have been diagnosed with complex medical conditions.
The successful candidate will have a strong clinical background and the ability to utilise their skills and experience to support our customers and their families when they need us most. You will be responsible for providing front-line support to our customers via all communication channels, including email and telephone.
Key aspects of the role include:
- Proactively reviewing the eligibility for customers to make use of their health policy in line with their policy cover.
- Signposting, where required, to enable access to other eligible services.
- Using clinical skills to make informed decisions on highly complex treatment eligibility, including levels of care, hospital length of stay and treatment options.
- Working proactively with providers to ensure care is appropriate to need and eligible under the customers policy.
- Maintaining up to date and accurate knowledge of current best practice and clinical guidelines.
- Supporting front line business areas where there are clinically complex cases to provide clinical case management support.
- Maintaining up to date and accurate knowledge of appropriate WPA products, policies, and initiatives to ensure that all queries are answered accurately.
- Carrying out medical research to support claim decisions and ensure current and accurate evidence to support claims advice.
We offer a contemporary working environment with a wide range of benefits, including free onsite parking. You will also play a critical role in WPA's future, knowing that you are key in retaining existing customers and where your contributions will always be valued.
We are a not-for-profit, environmentally friendly organisation whose ethos is treating others as we want to be treated, including our fabulous team, customers and local community. We hire great people, we believe in everyone and recognise that individual differences are what makes our team stronger.
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