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Case Manager - Health Insurance, Tewkesbury
Location: Tewkesbury, United Kingdom
Client:
Health and Care Management Ltd
Job Category:
-
EU work permit required:
Yes
Job Reference:
67042caed193
Job Views:
10
Posted:
05.05.2025
Expiry Date:
19.06.2025
Job Description:
About the Role
Location - Tewkesbury (hybrid working available)
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 long-term sickness and workplace absence. This role is suited to someone with experience in insurance, claims, or a clinical background coordinating care and treatment outcomes for the corporate market.
Key responsibilities:
1. Establish the current reason for ill health/injury and identify any underlying cause or contributory factors.
2. Support the assessment process by providing thorough and accurate information to assess personal and occupational risk factors.
3. Advise members on the reasons and multifactorial issues related to their health episode and how to mitigate these.
4. Follow managed care pathways, NICE, and other evidence-based clinical guidelines.
5. Review treatment options and make referrals for consultations, investigations, and treatment, considering private and NHS options.
6. Source appropriate treatment providers aligned with the rules and benefits of their health insurance plan.
7. Stay updated with the latest rules and benefits of each plan offered by our Corporate Customers, including changes and exceptions.
8. Collaborate with our onsite Functional Health team to manage referrals and provide comprehensive service.
9. Be proficient with Microsoft Office and confident with IT systems.
10. Maintain excellent communication skills, both telephonically and in writing.
11. Adopt an investigative and problem-solving approach.
12. Manage workloads effectively to meet customer service deadlines.
13. Experience in insurance or claims environment, healthcare preferred.
14. Understanding of clinical and non-clinical pathways.
15. Ability to conduct telephone assessments.
16. Hold a clinical qualification such as Sports Therapy, Physiotherapy, Nutrition, or Counselling.
17. Knowledge of GDPR, DPA, and ICO rules related to data protection.
DE&I
HCML is committed to equality of opportunity for all staff. Applications are encouraged regardless of age, disability, sex, gender reassignment, sexual orientation, pregnancy and maternity, race, religion or belief, marriage, and civil partnerships.
* 25 days annual leave
* Your birthday off
* 6% company pension contribution
* Bike to Work Scheme
* Enhanced Maternity/Paternity/Adoption and Shared Parental leave
* 2 voluntary days per year
* Long Service Awards
* CPD opportunities
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