Health & Care Management LTD (HCML)
Healthcare Plan Case Manager (Corporate Healthcare)
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Healthcare Plan Case Manager (Corporate Healthcare)
Healthcare Plan Case Manager
Location: Tewkesbury (Hybrid) Salary: £26,500 to £27,500 per annum Status: Permanent Working Hours: Mon - Fri, 8am - 6pm (Rotating schedule: 8am - 4:30pm, 9:30am - 6pm, & Flexi week)
About HCML
HCML is the UK’s leading provider of rehabilitation, case management, occupational health, and workplace wellbeing services. Ranked as a 2025 UK’s Best Workplace for Wellbeing, we prioritise the growth, development, and wellbeing of our teams.
About the Role
We are seeking a Healthcare Plan Case Manager to join our Healthcare Plan team, where you’ll provide a seamless, customer-focused experience for claimants. Your role involves:
- Supporting individuals through their healthcare journey with expert guidance and compassion.
- Managing cases with precision, aligning decisions with clinical best practice, plan rules, and regulatory standards.
- Balancing empathy with analytical thinking to improve people’s health and wellbeing.
Purpose of Role
To ensure members experience a smooth, compliant healthcare journey while upholding fair, transparent, and cost-effective claim management. You’ll act as a trusted advisor, helping members:
- Understand their condition.
- Navigate healthcare options.
- Engage actively in recovery.
- Adhere to plan-specific rules and benefits.
Key Responsibilities
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Case Assessment & Guidance
- Establish current ill health/injury causes and underlying risk factors.
- Conduct multidisciplinary assessments while gathering key risk information.
- Clearly explain multifactorial risks and empower members to address controllable factors.
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Compliance & Reimbursement
- Follow managed care pathways, NICE guidelines, and evidence-based standards.
- Evaluate both private and NHS treatment options before onward referrals.
- Strictly adhere to Rules & Benefits, ensuring cost fairness, regional compliance, and legal adherence.
- Manage escalations and CRM data entry accurately.
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Stakeholder Collaboration
- Work closely with the onsite Functional Health Team to expand case contexts and evaluate objective measurements.
- Maintain integrated health & risk management knowledge aligned with regulatory standards.
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Learning & Accountability
- Recognise training needs and escalate breaches (e.g., DPA issues) to senior leadership.
- Present a customer-focused, professional approach in internal/external communications.
- Innovate, monitoring performance via audits, system entries, CPD evidence, and reviews.
Person Specification
Experience
Essential:
- Proven ability to manage workloads under deadlines with minimal supervision.
- Demonstrated independence, knowing when to seek support strategically.
- Experience in productive working relationships, navigating multi-tiered dynamics.
Desirable:
- Prior claims management experience.
Skills & Knowledge
Essential:
- Technical proficiency with Microsoft Office (Excel, Outlook, Teams).
- Exceptional telephone etiquette—empathetic listening (inbound/outbound communication).
- Strong analytical thinking and problem-solving for obstacle removal.
- Ability to connect ill health effects to individual and workplace contexts.
- Unparalleled organisation/planning skills to meet objectives under pressure.
Desirable:
- Familiarity with clinical and non-clinical pathways.
- Understanding of GDPR, DPA, and ICO compliance principles.
- Knowledge of occupational health protocols, relevant legal frameworks, and ill health/injury management practices.
- Experience with telephone-based motivational interviewing techniques.
- Awareness of organisation-wide performance standards.
Attributes
- Empathetic communicator with a customer-first mindset.
- Self-driven and capable of autonomous, high-quality work.
- Proactive, scrutinising uncertainties and driving solutions.
- Detail-oriented, ensuring perfection in documentation and decisions.
- Resilient, adept at juggling conflicting priorities.
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Qualifications & Training
Essential:
- GCSE Maths & English (Grade C/4 or equivalent).
Desirable:
- Degree-baccalaureate or professional healthcare certification (e.g., occupational health, case management).
Company Benefits
Health & Wellbeing Support
- Medicash Health Cash Plan—claim back dental, optical, and chiropody costs; additional family coverage.
- 24/7 Digital Health—cessationless access to virtual GP consultation & EAP (Employee Assistance Programme).
- Free mental health support: Up to 8 funded sessions of face-to-face counselling or CBT.
Financial & Flexible Perks
- Pension scheme: With salary sacrifice options.
- Employee volunteering: Up to 2 fully paid community days per year.
- Flexible leave: 25 days annual leave + bank holidays, plus birthday leave.
- Holiday accrual flexibility: buy or sell up to 3 days annually.
- Payroll giving: Automate charitable donations pre-tax.
Inclusivity & Rewards
- Death in Service benefit galore for loved ones—4x base salary.
- Generous equality, diversity, and inclusion policies; candidates encouraged from all backgrounds.
- Professional growth: Funds post-probation registration, promotes to internal roles/secondments.
- Rewarding recognition: Annual pay reviews, staff awards, plus company events/activities.
HCML values equality. Applications are welcomed without discrimination regarding age, disability, gender, sexuality, religion, marriage status, or any protected characteristic.
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