This permanent, full-time Clinical Case Manager role sits in HCA UK's Case Management team, with a specialist oncology focus. The post reviews pre-authorisation requests for complex treatments such as chemotherapy, radiotherapy and bone marrow transplant against national standards and contract terms. It runs on weekday day shifts, fully on site, with a choice of 8am to 4pm or 9am to 5pm. A current SACT Passport is essential, and applications without one cannot be considered.
What the job involves
- Manage pre-authorisation requests for complex treatments and complete them on time under contract terms
- Carry out clinical reviews against nationally recognised, evidence-based standards and escalates cases where needed
- Assess medical necessity and level of care, making recommendations to physicians and medical directors
- Coordinate treatment plans and authorisations with clinical teams, provider networks and third-party payers
- Give clinical guidance to non-clinical colleagues
- Influence patient care pathways
- Keep accurate clinical documentation, support audit and contribute to quality improvement, efficiency and patient satisfaction
What’s required
Registration & licences
- NMC registration as an adult nurse
- Current SACT Passport
Experience
- Substantial post-registration experience with demonstrable paediatric exposure
- Extensive hands-on inpatient bedside nursing in both adult and paediatric services
- Strong inpatient nursing or insurance sector background in clinical case management or utilisation review
- Senior clinical experience, typically Band 6 or above, with leadership, service coordination, team supervision and/or management responsibilities
Skills & knowledge
- Leading complex clinical decision-making
- Influencing multidisciplinary teams
- Coordinating care across multiple stakeholders
- Excellent verbal and written communication
- Building effective relationships with clinical, operational and insurer stakeholders
What’s offered
- 25 days holiday plus bank holidays, rising with service, with option to buy or sell leave
- Private healthcare insurance for treatment at HCA hospitals
- Private pension contribution that rises with length of service
- Season ticket loan and cycle to work scheme
- Group life assurance from day one and critical illness cover
- Enhanced maternity and paternity pay
- Corporate staff discounts, including maternity packages at The Portland
- Flexible health, protection and lifestyle benefits, with discounts at over 800 retailers
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Contact Details:
The Methodist Church in Britain Recruitment Team
