Medical Case Manager

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Medical Case Manager

We have an opening for a Medical Case Manager position at Healix in our 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.

About the company

All around the world, Healix safeguards people's health and wellbeing.

Required Criteria

• Registered Nurse or Paramedic

Desired Criteria

• Case Management Experience
• Private Medical Insurance

Skills you'll need