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Healthcare Case Manager

1 month ago

Tewkesbury, Gloucestershire, United Kingdom Health Case Management Limited (HCML) Full time

Job Summary: We are seeking a skilled Healthcare Case Manager to join our team at Health Case Management Limited (HCML). As a key member of our team, you will be responsible for providing exceptional support to our members, ensuring they receive the best possible care and treatment.

Key Responsibilities:

  • Conduct thorough assessments to identify the current reason for ill health or injury and any underlying causes or contributory factors.
  • Support the multidisciplinary assessment process by providing accurate information to assess personal and occupational risk factors.
  • Advise members on the reasons and multifactorial issues associated with their current episode of ill health or injury and provide guidance on how to mitigate these.
  • Follow managed care pathways, NICE guidelines, and other evidence-based clinical guidelines.
  • Review private and NHS treatment options and make onward referrals for consultations, investigations, and treatment as needed.
  • Source appropriate treatment providers in line with the rules and benefits of our health insurance plans.
  • Stay up-to-date with the latest rules and benefits of each plan offered by our corporate customers, including changes, amendments, and exceptions.

Benefits:

  • 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)

Essential Skills:

  • Proficient with Microsoft Office packages and confident using IT systems in general
  • Excellent communication skills, both telephonically and in written communications
  • Able to adopt an investigatory and problem-solving mindset
  • Effective time management skills to deliver against customer service deadlines and expectations
  • Essential experience in an insurance or claims environment, preferably in healthcare
  • Understanding of clinical and non-clinical pathways
  • Ability to conduct telephone assessments

Desirable Experience:

  • Clinical qualification such as Sports Therapy, Physiotherapy, Nutrition, or Counselling
  • Knowledge of GDPR, DPA, and ICO rules and guidelines, and how they relate to protecting customers and their information