Medical Case Manager

Are you a Registered Nurse or Allied Health Professional looking for a rewarding role where you can combine your clinical expertise with case management and member support? At Healix Health, we're looking for a Clinical Case Manager to join our experienced team, supporting members through their healthcare journeys while ensuring access to high-quality, clinically appropriate and cost-effective care. This is an opportunity to make a real difference by guiding individuals through treatment pathways, liaising with leading healthcare providers, and delivering exceptional customer outcomes. Working closely with members, families, clinicians, healthcare providers, clients and internal teams, you will manage a varied caseload and play a key role in delivering a first-class healthcare funding and case management service. About The Role What You'll Be Doing As a Clinical Case Manager, you will:

Manage your own caseload, taking a proactive and member-focused approach to case management.Liaise with healthcare providers, consultants and treating clinicians to coordinate appropriate treatment and care.Monitor treatment plans and progress, ensuring care remains clinically appropriate and aligned to members' needs.Support discharge planning and ongoing care arrangements.Review healthcare costs and treatment pathways to ensure value and effective financial oversight.Assess treatment eligibility in line with scheme terms and conditions.Maintain accurate case records and documentation using our Case Management System.Provide support and guidance to members regarding healthcare claims and treatment options.Conduct Health Needs Assessments and provide wellbeing guidance, support and signposting where appropriate.Offer clinical expertise and advice to internal stakeholders and non-clinical teams.Contribute to service development, process improvement initiatives and clinical training activities. What We're Looking ForEssential

Registered Nurse (RN/RMN) with current professional registration and a minimum of two years' clinical experience; orAllied Health Professional with current HCPC registration and a minimum of two years' experience.Strong clinical assessment and decision-making skills.Excellent communication and relationship-building abilities.Ability to manage a varied workload and prioritise effectively.Strong attention to detail and organisational skills.Customer-focused approach with a commitment to delivering excellent service.Good IT skills, including Microsoft Office and digital case management systems. Desirable

Experience within case management, healthcare funding or healthcare claims.Knowledge of private medical insurance and claims processes.Understanding of healthcare funding pathways and provider networks.You'll thrive in this role if you're clinically credible, commercially aware and passionate about helping people navigate complex healthcare journeys. You'll enjoy building relationships, solving problems and working collaboratively to deliver outstanding outcomes for members and clients alike.

Required Criteria

Registered Nurse or Paramedic Desired Criteria

Case Management ExperienceGood understanding and previous experience of the private medical insurance industry and claims processing Skills Needed

Company Culture

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. Company 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, Free work laptop, Referral bonus, Open office, Competitive salary, Life insurance, Employee Assistance Scheme, Wellbeing Scheme, Social Opportunities, Progression opportunities Salary £40,000.00 - £42,000.00 per year