Medical Case Manager (RN)
We have two openings for a Medical Case Manager position at Healix in either our Bristol or Esher-based office.
Reporting to the Clinical Lead, the post holder will provide a confident, knowledgeable and efficient service to Healix members, via telephone (inbound and outbound) and email, managing claims and signposting to appropriate services included in the scheme benefits.
This role is more than simply assessing member claims, the post holder will be expected to use their clinical knowledge to ensure members feel supported during treatment, guiding, supporting and signposting to ensure best outcomes and service.
We are looking for candidates who meet the following criteria:
Registered RN, RMN or allied health professionals with an active HCPC registration.
Broad range of acute clinical experience.
Ability to deal calmly and professionally face to face or remotely with stakeholders at all levels.
A resilient manner and excellent communication skills, a mature confident approach and the ability to interact with individuals who are undergoing complex treatment and may be distressed, anxious or unhappy with the outcome of a cover decision.
Ability to use clinical and commercial skills to carefully balance member experience, treatment eligibility and cost effectiveness.
Awareness of own limitations, recognising when it is appropriate to escalate cases to the Head of Clinical Service for review.
About the role
Key activities/main duties:
Registered RN, RMN or allied health professionals with an active HCPC registration.
Broad range of acute clinical experience.
Ability to deal calmly and professionally face to face or remotely with stakeholders at all levels.
A resilient manner and excellent communication skills, a mature confident approach and the ability to interact with individuals who are undergoing complex treatment and may be distressed, anxious or unhappy with the outcome of a cover decision.
Ability to use clinical and commercial skills to carefully balance member experience, treatment eligibility and cost effectiveness.
Awareness of own limitations, recognising when it is appropriate to escalate cases to the Head of Clinical Service for review.
What you will need
Required criteria
- Registered Nurse or Paramedic
Desired criteria
- Case Management Experience
- Good understanding and previous experience of the private medical insurance industry and claims processing
Healix
All around the world, Healix safeguards people's health and wellbeing.
We offer UK employee healthcare benefits, and travel, medical and security assistance in every corner of the globe. Our purpose is to help people in difficult situations – whether that’s a cancer diagnosis, a need for medical assistance when they’re far from home, or being caught up in conflict or natural disaster. We talk to them, support them, and make sure they get the help they need. If necessary, we’ll pull them out and bring them home. We’re co-ordinators and problem-solvers: experts at navigating the global health and security landscape. Our teams of doctors, nurses, travel and medical co-ordinators and security experts make sure that your people will be looked after, whatever happens supported by technology designed help individuals, not slot them into a predetermined solution. We work with governments, broadcasters, NGOs, international corporations, major insurers and more. No two clients are the same: we adapt our services to their needs. More importantly, we adapt to the practical and human needs of the individuals we protect. Most of us are on the front line; we keep our back office lean. We don’t use scripts, and we don’t time calls. We never lose sight of the fact that we’re dealing with real people.
Instead, we focus on ensuring our highly trained specialists have the space and time they need to be effective. We let them use their initiative to get the job done, because the situations they face often throw up unexpected challenges – and no protocol survives contact with the real world. Our clients have thousands of employees and customers, at home and abroad, so they need a business big enough to handle any situation. But they chose Healix because they also need an organisation that’s personal enough to care. Our people are driven to do things in the best way, not the way they have always been done. We work hard, and our efforts are rewarded with great development opportunities and a supportive team spirit. We want to nurture this friendly and dynamic company culture so that we can continue to attract diverse talent with a breadth of knowledge and world-class skills. As a part of Healix, you can expect a range of excellent benefits and an environment where people really do care.
Our benefits
Commitment to career development We are committed to helping our people build and develop successful careers. Our employees are given direct responsibility and opportunity to develop and grow whilst working on challenging and worthwhile projects in a rewarding and supportive environment. We invest in the continuous development of our team, offering on-going training and professional enhancement opportunities for those wishing to diversify or take additional responsibilities.
Health insurance
Vacation, Paid time off
Retirement plan and/or pension
Office perks
Employee development programs
Employee discounts
Gym membership or wellness programs
Opportunity to travel
Casual dress
Cycle to work
Open office
Competitive salary
Life insurance
Employee Assistance Scheme
Wellbeing Scheme
Social Opportunities
Hybrid Working
Medical Case Manager (RN)
All around the world, Healix safeguards people's health and wellbeing.