Healthcare Plan Case Manager

HCML; Tewkesbury; On-site; GBP 25,000 - 45,000

Job description

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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.

Job Opportunity

Key responsibilities:

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

Key skills/experience:

• Proficient with Microsoft Office packages and confident using IT systems in general.
• Excellent communication skills, both telephonically and in written communications.
• Adopt an investigatory and problem-solving mindset.
• Manage workloads effectively to deliver against customer service deadlines and expectations.
• Essential experience:
• Experience working in an insurance or claims environment (healthcare strongly preferred).
• Understanding of clinical and non-clinical pathways.
• Ability to conduct telephone assessments.

Desirable experience:

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

Company 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.