Job Description:
Clinical Case Manager
Bupa Place, Salford Quays / Angel Court, London –
Permanent
Full time -
£36k
We make health happen:
At Bupa, our purpose is simple: helping people live longer, healthier, happier lives and making a better world. As a Clinical Case Manager, you’ll be the first point of contact for our customers and providers, guiding them through treatment authorisations and ensuring they receive the right care under their policy. You’ll combine clinical expertise with customer care, making decisions that protect both health outcomes and policy integrity. This is a role where your professional judgement and compassion truly make a difference.
How you’ll help us make health happen:
1. Respond to queries from customers and providers via phone, email and systems, explaining benefit entitlements and treatment decisions.
2. Interpret Bupa UKI policy and apply correct codes for accurate processing.
3. Maintain clinical records in line with NMC/HCPC standards and data protection requirements.
4. Guide customers to the most suitable treatment pathways, identifying opportunities to reduce future claim expense.
5. Act as an escalation point for clinically complex cases and support case management.
6. Identify and escalate concerns such as fraud or abuse, contributing to solutions that improve performance and customer experience.
7. Share knowledge with colleagues and maintain accurate daily activity records to meet KPIs.
Key Skills / Qualifications needed for this role:
8. Registration with the NMC as a Registered General Nurse is absolutely essential for this role and a speciality such as obstetrics and/or gynaecology is desirable.
9. At least 5 years post qualification experience is required to be considered for this role.
10. Proven health coaching and clinical case management experience is highly desirable.
11. The ability to work independently within your scope of practice, using sound judgement and empathy.
12. Strong communication skills – you’ll be comfortable handling sensitive conversations with compassion and clarity.
13. Confidence using multiple systems and tools at once – you’ll be talking and typing at the same time.
14. A calm, resilient approach – especially when supporting vulnerable or anxious customers.
15. A problem-solving mindset – you’ll think analytically to find the best outcomes for our customers.
16. Previous contact centre experience is desirable as the role is heavily phone based, but not essential.
Benefits
Our benefits are designed to make health happen for our people. Viva is our global wellbeing programme and includes all aspects of our health – from mental and physical, to financial, social and environmental wellbeing. We support flexible working and have a range of family friendly benefits.
17. 25 days holiday, increasing through length of service, with option to buy or sell
18. Bupa health insurance as a benefit in kind
19. An enhanced pension plan and life insurance
20. Onsite gyms or local discounts where no onsite gym available
21. Various other benefits and online discounts
Why Bupa?
We’re a health insurer and provider. With no shareholders, our customers are our focus. Our people are all driven by the same purpose – helping people live longer, healthier, happier lives and making a better world. We make health happen by being brave, caring and responsible in everything we do.