Case Manager - Health Insurance

www.topfinancialjobs.co.uk - Jobboard; Tewkesbury; On-site; GBP 25,000 - 27,000; Full time

Job summary

An innovative company is seeking a Healthcare Plan Case Manager to ensure members receive the best support and treatment through their healthcare plan. This role focuses on providing guidance during claims, using a clinical background to coordinate care effectively. With hybrid working options available, you'll be part of a dedicated team that values employee wellbeing and offers extensive benefits, including generous leave and professional development opportunities. If you're passionate about making a difference in healthcare and have experience in insurance or claims, this is the perfect opportunity for you.

Benefits

25 days annual leave

Birthday off

6% company pension contribution

Bike to Work Scheme

Medicash Health plan

Enhanced Maternity/Paternity/Adoption leave

2 voluntary days per year

Long Service Awards

Employee Wellbeing Seminars

CPD opportunities

Qualifications

• Experience in insurance or claims environment, preferably healthcare.
• Understanding of clinical and non-clinical pathways.

Responsibilities

• Establish reasons for ill health/injury and identify underlying causes.
• Support multidisciplinary assessment processes with accurate information.
• Advise members on mitigating health issues and follow care pathways.

Skills

Microsoft Office

Communication Skills

Problem Solving

Workload Management

Insurance/Claims Experience

Clinical Pathways Understanding

Telephone Assessments

Education

Clinical Qualification (e.g., Sports Therapy, Physiotherapy)

Tools

IT Systems

Job description

Healthcare Plan Case Manager

Location - Tewkesbury (hybrid working available)

Salary - 25,000 - 27,000

Our HCP Case Managers provide an effortless journey for all members making claims through their company Healthcare Plan, ensuring they receive the best support, advice and treatment in line with the rules and benefits offered through their healthcare plan scheme. Our aim is to help our members live a healthier, happier life and reduce things like long-term sickness and workplace absence. This role is particularly suited to someone with experience in the insurance or claims industry, or with 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.
• To advise the member 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
• Where appropriate, 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

Company 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

Key skills/experience:

• Proficient with Microsoft Office packages and confident using IT systems in general
• Excellent communication skills, both telephonically and in written communications
• Adopt an investigatory and problem solving mindset
• Manage 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

Desirable experience:

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

Creating an Inclusive Environment

HCML is committed to equality of opportunity for all staff and applications from individuals are encouraged regardless of age, disability, sex, gender reassignment, sexual orientation, pregnancy and maternity, race, religion or belief and marriage and civil partnerships