Clinical Case Manager (Pre-Authorisation)

HCA Healthcare UK; City Of London; On-site; GBP 42,000 - 54,000; Full time

Benefits offered by this job

25 days holiday

Private Healthcare Insurance

Private pension contribution

Season Ticket Loan

Cycle to Work

Group Life Assurance

Critical illness cover

Enhanced Maternity and Paternity pay

Corporate staff discount

Flexible health, protection and life–l

Discounts with over 800 major retailer

Job summary

HCA UK’s Leaders in Oncology Care in London is seeking a Clinical Case Manager (Pre-Authorisation) to join the Case Management team. The role is full time, on site, 37.5 hours, with options for 8am-4pm or 9am-5pm.

Ideal candidates are experienced Band 6 nurses or healthcare professionals with paediatric and inpatient bedside nursing experience, capable of complex clinical decision-making and collaboration with consultants, insurers and operational stakeholders.

Qualifications

• NMC registered adult nurse with paediatric exposure and post-registration experience.
• Hands-on inpatient nursing across adult and paediatric services.
• Senior clinical experience in case management or utilisation review.
• Experience in healthcare insurance sector preferred.

Responsibilities

• Manage pre-authorisation requests for complex treatments and ensure timely completion.
• Conduct clinical reviews using evidence-based standards and elevate cases where appropriate.
• Assess medical necessity and level of care, making recommendations to Physicians and Medical Directors.
• Collaborate with clinical teams, provider networks and third-party payors to coordinate patient treatment plans and authorisations.
• Maintain accurate clinical documentation, support audit activity and contribute to quality improvement initiatives.

Skills

NMC registered nurse

Paediatric experience

Inpatient nursing

Clinical case management

Leadership

Stakeholder collaboration

Communication skills

Education

Registered Nurse with Band 6 level

Job description

Clinical Case Manager (Pre-Authorisation)

Location: Leaders in Oncology Care, London
This role is based fully on site
Full time, 37.5 hours per week
Monday to Friday, with a choice of 8am-4pm or 9am-5pm
Permanent contract
Salary: Competitive

We’re looking for a Clinical Case Manager (Pre-Authorisation) to join our Case Management team. This opportunity is ideally suited to an experienced Band 6 (or equivalent) nurse or healthcare professional with extensive inpatient bedside nursing experience across both adult and paediatric care, or a senior nurse with a strong background within the healthcare insurance sector. You’ll bring the confidence to make complex clinical decisions, challenge where appropriate, and work collaboratively with consultants, nursing teams, insurers and operational stakeholders to ensure patients receive safe, timely and cost-effective care throughout their healthcare journey.

As a Clinical Case Manager, you’ll use your clinical expertise to assess pre-authorisation requests for complex treatments including chemotherapy, radiotherapy and bone marrow transplant cases, ensuring all reviews are completed in line with national standards, evidence-based practice and contractual requirements. Working collaboratively across multidisciplinary teams, you’ll influence patient care pathways, provide clinical guidance to non-clinical colleagues and help drive quality, efficiency and patient satisfaction.

Above all else, we’re committed to the care and improvement of human life. It’s this guiding vision that influences everything we do at HCA UK. From the CEO to the colleagues on the floor we all have a part to play in delivering exceptional care to our patients. Other’s may think this is just a role in Case Management, but to us, you’ll be part of a wider team with a unique sense of purpose, one that helps improve lives on a daily basis.

What you’ll do:

• Manage pre-authorisation requests for complex treatments and ensure timely completion in line with contractual requirements.
• Conduct clinical reviews using nationally recognised, evidence-based standards and elevate cases where appropriate.
• Assess medical necessity and level of care requirements, making recommendations to Physicians and Medical Directors.
• Collaborate with clinical teams, provider networks and third-party payors to coordinate patient treatment plans and authorisations.
• Maintain accurate clinical documentation, support audit activity and contribute to quality improvement initiatives.

What you’ll bring:

• Registered with the NMC as an Adult Nurse, with substantial post-registration experience and demonstrable exposure to paediatric care.
• Extensive inpatient bedside nursing experience across both adult and paediatric services. (Candidates must have hands-on clinical experience in both settings, not one or the other.)
• Strong background in inpatient nursing or insurance sector in a clinical case management or utilisation review capacity.
• Senior-level clinical experience, typically at Band 6 or above (or equivalent), with demonstrable clinical leadership, service coordination, team supervision and/or management responsibilities.
• Proven ability to lead complex clinical decision-making, influence multidisciplinary teams and coordinate care across multiple stakeholders.
• Excellent verbal and written communication skills with the ability to build effective relationships across clinical, operational and insurer stakeholders

Why HCA UK?

Originally founded over 50 years ago by Dr Thomas Frist, HCA has gone on to become one of the world’s leading healthcare providers. In the UK, we’re one of the largest providers of privately funded healthcare and have invested over £500 million in the latest treatments, technology, techniques, medication and facilities. Being part of a large multisite, established healthcare group we can offer you unrivalled opportunities for career progression through internal and external courses, as well as working conditions that prioritise both your mental and physical wellbeing.

By caring for our colleagues, we empower them to provide exceptional care for our patients. That’s why we offer a host of flexible benefits that reflect the invaluable contribution they make every day. As a Clinical Case Manager (Pre-Authorisation) you’ll be eligible for:

• 25 days holiday each year (plus bank holidays) increasing with service, with option to buy or sell leave to suit you
• Private Healthcare Insurance for treatment at our leading hospitals
• Private pension contribution which increases with length of service
• Season Ticket Loan and Cycle to Work scheme
• Group Life Assurance from day one
• Critical illness cover
• Enhanced Maternity and Paternity pay
• Corporate staff discount for all facilities including Maternity packages at The Portland
• Comprehensive range of flexible health, protection and lifestyle benefits to suit you
• Discounts with over 800 major retailers

Culture and values

• Unique and Individual: We recognise and value everyone as unique and individual
• Kindness and compassion: We treat people with kindness and compassion
• Honesty, integrity and fairness: We act with absolute honesty, integrity and fairness
• Loyalty, respect and dignity: We trust and treat one another as valued members of the HCA UK family with loyalty, respect and dignity

Reasonable adjustments

We believe everyone should feel comfortable to bring their full self to work and be afforded the same opportunities. As a Disability Confident committed organisation, we’re happy to discuss flexible working arrangements to suit your needs as well as offer reasonable adjustments throughout our recruitment process, and in the workplace, to anyone that needs them.