Case Manager - Health Insurance

Health Case Management Limited; Tewkesbury; Hybrid; GBP 24,000 - 27,000; Full time

Job summary

An established industry player is seeking a Healthcare Plan Case Manager to provide exceptional support for members navigating their healthcare claims. This role is vital in ensuring members receive the best advice and treatment aligned with their healthcare plan, helping them lead healthier lives while minimizing workplace absences. Ideal candidates will have a background in insurance or claims, coupled with strong clinical coordination skills. This position offers hybrid and remote work options, making it a flexible opportunity for the right individual. Join a team dedicated to enhancing member wellbeing and making a positive impact in healthcare management.

Benefits

25 days annual leave

Your 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 assessments and advise members on health issues.
• Review treatment options and manage referrals for consultations.

Skills

Microsoft Office proficiency

Excellent communication skills

Investigatory mindset

Problem-solving skills

Workload management

Education

Clinical qualification (Sports Therapy, Physiotherapy, Nutrition, Counselling)

Tools

IT systems

Job description

Role Overview

Key responsibilities:

1. Establish the current reason for ill health/injury and identify any underlying cause or contributory factors.
2. Support the multidisciplinary assessment process by providing thorough and accurate information to assess personal and occupational risk factors.
3. 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.
4. Follow managed care pathways, NICE and other evidence-based clinical guidelines.
5. Where appropriate, review private and NHS treatment options when making onward referrals for consultations, investigations, and treatment.
6. Source appropriate treatment providers, in line with the rules and benefits of their health insurance plan.
7. Keep up to date with the latest rules and benefits of each plan offered by our Corporate Customers, including changes, amendments, and exceptions.
8. Work seamlessly with our onsite Functional Health team to manage referrals and provide three-dimensional service.

About the Role

Healthcare Plan Case Manager

Location - Tewkesbury (hybrid and remote options available)

Salary - £24,000 - £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.

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:

1. Proficient with Microsoft Office packages and confident using IT systems in general.
2. Excellent communication skills, both telephonically and in written communications.
3. Adopt an investigatory and problem-solving mindset.
4. Manage workloads effectively to deliver against customer service deadlines and expectations.

Essential experience:

1. Experience working in an insurance or claims environment (healthcare strongly preferred).
2. Understanding of clinical and non-clinical pathways.
3. Ability to conduct telephone assessments.

Desirable experience:

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