Clinical Case Manager (Mental Health)

TN United Kingdom; London; On-site; GBP 35,000 - 55,000; Full time

Job summary

An established industry player in health insurance is seeking a Clinical Case Manager to provide exceptional service to customers and providers. In this role, you will manage inquiries, ensure treatment authorizations, and guide clients through their health journeys. Your expertise will help optimize operational performance while maintaining compliance with policies. This position offers a chance to make a real impact in the lives of vulnerable individuals, working in a supportive environment that values resilience and effective communication. Join a team dedicated to improving health outcomes and enjoy a range of flexible benefits.

Benefits

Flexible working

Health and wellbeing programs

Holiday entitlements

Health insurance

Pension plans

Onsite gyms or discounts

Various online benefits

Qualifications

• 5+ years experience in CAMHS and/or working with young people is essential.
• Ability to work effectively independently and as part of a team.

Responsibilities

• Respond to queries and support members, providers, and colleagues via various communication channels.
• Guide customers and providers on treatment policies and identify opportunities to reduce future claim expenses.

Skills

CAMHS experience

Experience with neurodivergent individuals

Risk management

Safeguarding knowledge

Analytical problem-solving

PC literacy

Familiarity with CRM systems

Effective communication

Resilience in high-pressure environments

Job description

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Clinical Case Manager (Mental Health), Central London

Client: Bupa

Location: Central London, United Kingdom

Job Category: -

EU work permit required: Yes

Job Reference: 3a7eaef8ceae

Job Views: 3

Posted: 26.04.2025

Expiry Date: 10.06.2025

Job Description:

Clinical Case Manager (Mental Health)

Location: Salford Quays / London –

Type: Permanent, Full time

Job Summary: As a Clinical Case Manager, you will provide a confident, knowledgeable, and efficient front-line service to Bupa customers and providers via inbound and outbound calls, including administrative tasks such as signposting to enable customer access to eligible services through their Bupa policy. Your responsibilities include ensuring customer eligibility, preauthorizing or declining treatments in line with policy coverage, and guiding customers to the most suitable treatment pathways. You will also contribute to clinical, commercial, and operational performance, ensuring capacity and capability are optimized.

Key Responsibilities:

• Respond to queries and support members, providers, and colleagues via various communication channels.
• Explain treatment authorizations, declines, and benefit entitlements.
• Maintain accurate knowledge of Bupa products, policies, and initiatives.
• Interpret policies and use correct codes for data processing.
• Use Bupa systems proficiently, ensuring compliance and maintaining accurate records.
• Guide customers and providers on treatment policies and identify opportunities to reduce future claim expenses.
• Serve as an escalation point for complex cases and provide clinical case management support.
• Identify and escalate concerns such as fraud or incidents.
• Support colleagues and contribute to business performance improvements.
• Maintain records of activities for reporting and achieve KPIs.

Qualifications and Skills:

• 5+ years experience in CAMHS and/or working with young people is essential.
• Experience with neurodivergent individuals is desirable.
• Risk management experience and safeguarding knowledge.
• Ability to work effectively independently and as part of a team.
• Calm, professional handling of challenging conversations.
• Resilience in high-pressure environments dealing with vulnerable customers.
• Confident, mature, and compassionate communication skills.
• Analytical problem-solving skills.
• PC literacy and familiarity with CRM systems.

Our benefits include flexible working, health and wellbeing programs, holiday entitlements, health insurance, pension plans, onsite gyms or discounts, and various online benefits.

Why Bupa?

We are a health insurer and provider committed to helping people live longer, healthier, happier lives. Our focus is on our customers, and our employees are driven by purpose — making health happen by being brave, caring, and responsible in everything we do.