Hybrid Clinical Case Manager – Complex Care Navigator

Vitality; Stockport; Hybrid; GBP 42.000 - 64.000; Vollzeit

Benefits dieser Stelle

Bonus schemes

Pension up to 12%

Vitality health insurance

Life Assurance

Zusammenfassung

Vitality is seeking a Clinical Case Manager to join the Complex Care Team in the UK. You will manage complex, long-term healthcare claims, including oncology cases, ensuring members receive the right benefits and proactive care.

You will coordinate with providers, support members through the journey and make informed decisions within approved authority levels. The role is hybrid with 2 days in the office and 35 hours per week, offering flexible working arrangements and comprehensive benefits.

Qualifikationen

• Registered nurse or equivalent clinical qualification with current practice.
• Strong understanding of medical conditions and treatment options.
• Ability to interpret complex information and make informed claims decisions.

Aufgaben

• Manage a portfolio of complex, long-term healthcare claims and eligibility.
• Provide compassionate support and explain the case management process to members.
• Analyse clinical and policy information to make accurate decisions within authority levels.
• Coordinate with consultants, hospitals, and providers for timely decisions.
• Navigate members to appropriate treatment pathways and preferred providers.
• Identify opportunities for sustainable claims savings through provider management and NHS benefits.
• Act as a reference for complex queries and escalate as needed.
• Maintain complete records of member contact, eligibility, decisions and outcomes.
• Support audits, projects and development of Complex Care processes.
• Share knowledge, mentor colleagues and support induction of new Case Managers.

Kenntnisse

Clinical Case Management

Clinical Decision Making

Complex Care Navigation

Ausbildung

Registered Nurse (RN)

Other clinical qualification (Doctor / PAM / RGN / SRN / ENG)

Tools

Microsoft Word

Microsoft Excel

Jobbeschreibung

Vitality is seeking a Clinical Case Manager to join the Complex Care Team in the UK. You will manage complex, long-term healthcare claims, including oncology cases, ensuring members receive the right benefits and proactive care.

You will coordinate with providers, support members through the journey and make informed decisions within approved authority levels. The role is hybrid with 2 days in the office and 35 hours per week, offering flexible working arrangements and comprehensive benefits.