Healthcare Case Manager
6 days ago
We are seeking a skilled Healthcare Case Manager to join our team at Health and Care Management Ltd. As a key member of our team, you will play a vital role in ensuring our members receive the best support, advice, and treatment in line with the rules and benefits of their healthcare plan scheme.
The ideal candidate will have experience in the insurance or claims industry, or a solid clinical background coordinating care and treatment outcomes for the corporate market.
Key Responsibilities- Establish the current reason for ill health/injury and identify any underlying cause or contributory factors.
- 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 their health insurance plan.
- 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.
- Proficient with Microsoft Office packages and confident using IT systems in general.
- Excellent communication skills, both telephonically and in written communications.
- Adept at managing workloads effectively to deliver against customer service deadlines and expectations.
- Essential experience:
- Experience working in an insurance or claims environment (healthcare strongly preferred).
- Understanding of clinical and non-clinical pathways.
- Ability to conduct telephone assessments.
- 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).
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