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Clinical Case Manager (Mental Health), Central London
Client: Bupa
Location: Central London, United Kingdom
Job Category: -
EU work permit required: Yes
Job Reference: 3a7eaef8ceae
Job Views: 3
Posted: 26.04.2025
Expiry Date: 10.06.2025
Job Description:
Clinical Case Manager (Mental Health)
Location: Salford Quays / London –
Type: Permanent, Full time
Job Summary: As a Clinical Case Manager, you will provide a confident, knowledgeable, and efficient front-line service to Bupa customers and providers via inbound and outbound calls, including administrative tasks such as signposting to enable customer access to eligible services through their Bupa policy. Your responsibilities include ensuring customer eligibility, preauthorizing or declining treatments in line with policy coverage, and guiding customers to the most suitable treatment pathways. You will also contribute to clinical, commercial, and operational performance, ensuring capacity and capability are optimized.
Key Responsibilities:
* Respond to queries and support members, providers, and colleagues via various communication channels.
* Explain treatment authorizations, declines, and benefit entitlements.
* Maintain accurate knowledge of Bupa products, policies, and initiatives.
* Interpret policies and use correct codes for data processing.
* Use Bupa systems proficiently, ensuring compliance and maintaining accurate records.
* Guide customers and providers on treatment policies and identify opportunities to reduce future claim expenses.
* Serve as an escalation point for complex cases and provide clinical case management support.
* Identify and escalate concerns such as fraud or incidents.
* Support colleagues and contribute to business performance improvements.
* Maintain records of activities for reporting and achieve KPIs.
Qualifications and Skills:
* 5+ years experience in CAMHS and/or working with young people is essential.
* Experience with neurodivergent individuals is desirable.
* Risk management experience and safeguarding knowledge.
* Ability to work effectively independently and as part of a team.
* Calm, professional handling of challenging conversations.
* Resilience in high-pressure environments dealing with vulnerable customers.
* Confident, mature, and compassionate communication skills.
* Analytical problem-solving skills.
* PC literacy and familiarity with CRM systems.
Our benefits include flexible working, health and wellbeing programs, holiday entitlements, health insurance, pension plans, onsite gyms or discounts, and various online benefits.
Why Bupa?
We are a health insurer and provider committed to helping people live longer, healthier, happier lives. Our focus is on our customers, and our employees are driven by purpose — making health happen by being brave, caring, and responsible in everything we do.
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