Clinical Case Manager

• 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.

• 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.

We'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. We incentivise people to live healthier longer lives – they benefit, our business benefits, and society benefits. We’re successful because we attract, develop, and retain the best people – and because we care.

At 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 sustainability

Vitality 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. #LI-Hybrid

If we are fortunate in receiving a high volume of quality applications we may need to close this vacancy early. If you are interested, please submit your application as soon as possible.