Senior Clinical Case Manager

WPA Health Insurance; Taunton; On-site; GBP 32,000 - 36,000; Full time

Benefits offered by this job

Private medical insurance

WPA cash plan

Private remote GP services

Additional annual leave

Pension scheme

Length of service awards

Free onsite parking

Team social events

Contemporary working environment

Professional development support

Ongoing development opportunities

Job summary

WPA Health Insurance is seeking an experienced Senior Clinical Case Manager to support customers with complex medical needs at pivotal moments in their healthcare journey. The role is office-based in Taunton, offering a salary rising on probation and a 37-hour week with flexible patterns where possible.

You will join a clinical team that provides specialist support, working with NHS and private sector input to guide claims decisions and care options, while developing your clinical expertise and

Qualifications

• Registered healthcare professional with relevant qualification.
• Experience managing patients with complex healthcare needs.
• Ability to assess clinical information and make evidence-based decisions.
• Strong communication and customer service skills.

Responsibilities

• Be part of the customer pathway, proactively reviewing customers' eligibility to use their health policy in line with policy cover.
• Signpost customers to enable access to other eligible services.
• Use clinical skills to make informed decisions on complex treatment eligibility and levels of care.
• Work with providers to ensure care is appropriate to need and policy.
• Stay informed of current clinical best practice and emerging developments.
• Support front-line business areas where clinically complex cases require management.
• Maintain up-to-date knowledge of WPA products, policies and initiatives.
• Carry out medical research to support claims decisions and ensure evidence informs advice.

Skills

Healthcare qualification

Clinical case management

Evidence-based decision making

Excellent communication

Organised

Education

Nursing degree

Job description

We are looking for an experienced healthcare professional to join WPA as a Senior Clinical Case Manager, supporting customers with complex medical needs at some of the most important moments in their healthcare journey.

This is an exciting opportunity to use your clinical knowledge in a supportive, customer-focused environment while developing your career with an award-winning private health insurer.

• Salary: £31,930, rising to £35,535 on successful completion of probation.
• Hours: 37 hours per week, Monday to Friday between 08:00 and 18:00; flexible working patterns can be considered.
• Location: Office-based at our offices on Blackbrook Business Park in Taunton, TA1 2PE.

About us

WPA is a private healthcare provider with more than 100 years' experience of treating our customers as we would wish to be treated. We have won many awards for the level of service we provide and are the only Which? Recommended Provider for private medical insurance.

As a not-for-profit organisation, we look after our customers and our people, who are key to our success. You'll feel proud to work for WPA because of our inclusive culture, career progression opportunities and generous benefits.

Benefits and Development Opportunities

Alongside an attractive salary and annual non-contractual bonus, we offer a range of benefits and opportunities designed to support your wellbeing and professional development.

• Private medical insurance, a WPA cash plan and private remote GP services.
• The option to purchase additional annual leave.
• A pension scheme and length of service awards.
• Free onsite parking at our Taunton office.
• Regular social events, including BBQs, annual parties, team-building activities and sporting events.
• A contemporary working environment where your contribution is valued.
• Opportunities to build on your clinical experience and develop new skills.
• Ongoing support for your professional and personal development.

The team and role

The Clinical Team brings together a diverse range of healthcare, clinical and life sciences expertise, including nurses, paramedics and PhD-qualified professionals. Together, we provide specialist support to customers facing complex medical conditions, including cancer, helping them navigate their healthcare journey with confidence.

Acting as a single point of contact, the team supports customers throughout their treatment journey, providing guidance and continuity at every stage. We work closely with healthcare professionals and providers to gather the information needed to assess and manage complex medical claims. The team is also supported by our Chief Medical Officer and Medical Advisers, all practising specialists across the NHS and private sector, who provide expert input on complex cases and help ensure customers can access appropriate treatment and care.

You'll join a supportive and collaborative environment where your contribution is valued and your development is encouraged. This role offers the opportunity to build on your clinical expertise, develop new skills, and make a meaningful difference to customers during some of the most significant moments in their healthcare journey.

About you

You will:

• Hold a relevant healthcare qualification, such as nursing, paramedicine, life sciences or a related field.
• Have experience managing or supporting patients with complex healthcare needs.
• Be confident assessing clinical information and making evidence-based decisions.
• Demonstrate excellent communication skills when engaging with customers, healthcare professionals and providers.
• Be highly organised, with strong attention to detail and a commitment to delivering outstanding customer service.

In this role, you will:

• Be part of the customer pathway, proactively reviewing customers' eligibility to use their health policy in line with their policy cover.
• Signpost customers where required to enable access to other eligible services.
• Use clinical skills to make informed decisions on highly complex treatment eligibility, including levels of care, hospital length of stay and treatment options.
• Work proactively with providers to ensure care is appropriate to need and eligible under the customer’s policy.
• Stay informed of current clinical best practice, evidence-based guidelines and emerging healthcare developments.
• Support front-line business areas where clinically complex cases require clinical case management support.
• Maintain up-to-date and accurate knowledge of appropriate WPA products, policies and initiatives to ensure all queries are answered accurately.
• Carry out medical research to support claims decisions and ensure current, accurate evidence informs claims advice.

Be yourself and thrive

WPA is a not-for-profit, environmentally friendly organisation with an ethos of treating others as we would want to be treated, including our team, customers and local community. We hire great people, believe in everyone and recognise that individual differences make our team stronger.