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Clinical case manager

Bournemouth
Vitality
Clinical case manager
Posted: 17h ago
Offer description

Job Description

About The RoleTeam – Vitality CareWorking Pattern - Hybrid – 2 days per week in either the Vitality Bournemouth or Stockport Office. Full time, 35 hours per week. We are happy to discuss flexible working!Top 3 skills needed for this role:
* Strong Communication
* A proven Clinical background
* The ability to provide the very best Customer Service
What this role is all about:Within this exciting role in the Complex Care Team, you will be providing world class customer service whilst assessing and managing claims for our customers who need long term care of complex conditions. This role is essential in making sure our customers have access to their entitled benefits and treatments whist finding cost saving opportunities. Key Actions
* You will provide case management of assigned claims whilst providing a professional, compassionate world class standard of customer service. Case management includes: assessing and reassessing claims eligibility throughout the duration of the claim, introductory calls to members explaining case management and obtaining an AMI, identifying cost saving opportunities, and offering our partner’s services when appropriate.
* Highly proactive case management and care navigation, which will include regular contact with care providers (consultants, hospitals, clinics etc). This will make sure we have the all the needed information to make the right decision in a timely manner.
* Analysing relevant information to make the appropriate technical decision within own levels of authority, ensuring that claims stances are always followed, and that the decision is made by the correct team.
* Expert point of reference for customers and their representatives, colleagues, CSD and, the wider business to resolve Complex Claim queries and escalations.
* Maximise possible savings through proactive claims management. To include but not limited to: NHS and extended NHS cash benefit, offering of home care providers where appropriate, identifying ineligible claims costs, care navigation to preferred partners, and regular provider management contacts. Maintenance of accurate records to support savings MI.
* Achieve set targets/benchmarks for quality and productivity. Maintenance of accurate records to support quality and productivity.
* Involvement in project work as required to assist management in meeting business requirements, e.g. audits, specific projects etc.
* To maintain a positive and pro-active manner in carrying out all tasks, acting as a champion for change and supporting management decisions, so as to contribute to good team spirit and cohesion. Share knowledge and expertise within the team. Support induction and training of new Case Managers. To include the development of training plans and material, mentoring, coaching and quality audits as appropriate.
What do you need to thrive?
* Registered Nurse or other associated qualification, (Doctor, PAM RGN, SRN or ENG)
* PC literate with excellent knowledge of Word and Excel applications
* Excellent telephony and written skills
* Excellent communication, interpersonal and organisational skills
* Excellent understanding of medical conditions, their treatments and medical specialities.
So, what’s in it for you?
* Bonus Schemes – A bonus that regularly rewards you for your performance
* A pension of up to 12%– We will match your contributions up to 6% of your salary
* Our award-winning Vitality health insurance – With its own set of rewards and benefits
* Life Assurance – Four times annual salary
These are just some of the many perks that we offer! To view the extensive range of benefits we offer, please visit our careers page. Fantastic Benefits. Exciting rewards. Great career opportunities!If you are successful in your application and join us at Vitality, this is our promise to you, we will:
* Help you to be the healthiest you’ve ever been.
* Create an environment that embraces you as you are and enables you to be your best self.
* Give you flexibility on how, where and when you work.
* Help you advance your career by playing you to your strengths.
* Give you a voice to help our business grow and make Vitality a great place to be.
* Give you the space to try, fail and learn.
* Provide a healthy balance of challenge and support.
* Recognise and reward you with a competitive salary and amazing benefits.
* Be there for you when you need us.
* Provide opportunities for you to be a force for good in society.
We commit to all these things because we want you to feel that you belong, and are supported to be happy and healthy.About The CompanyWe're really excited to announce that we have recently been awarded "Top 10 Best Places To Work" in The Sunday Times Awards 2024!Vitality is a multi-award-winning UK insurance brand, here to make the world a healthier, happier place.We’ve been a purpose and values-driven business from day 1- long before it became fashionable. Our core purpose is to make people healthier and enhance protect their lives. Vitality pioneered shared-value insurance. Diversity & InclusionAt Vitality, we’re committed to diversity and inclusion because it’s good for our employees, for our business, and for society. We welcome applications from individuals of all backgrounds, experiences, and perspectives.Vitality’s approach to sustainabilityVitality is a business that drives positive change. We reward people for making and sustaining healthier choices. But healthy people also need a healthy environment. To learn more please visit our Careers page. If we are fortunate in receiving a high volume of quality applications we may need to close this vacancy early.

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