Vitality Care consultant

Overall Job Purpose

To provide customers with a personal and professional case-management service, making savings where appropriate and providing an informed advice service to customers and providers alike.

Accountabilities

• Case management of referred claims, providing a professional, World Class standard of Customer Service by answering telephone and written queries using standard processes and procedures.
• Provision/ownership of personalised and dedicated support to VitalityCare customers and their representatives
• Management and review of own case load. Assess assigned cases by obtaining and analysing relevant information in order to make the appropriate technical decision within own levels of authority. Maintain complete and accurate records of all customer interaction to ensure continuity of service
• Expert point of reference for customers and their representatives, colleagues, CSD and, the wider business to resolve VitalityCare queries and escalations
• Maximise possible savings through required levels of interventions/challenges. To include but not limited to; NHS and extended NHS cash benefit, bill and invoice audit, liaising with consultants and hospitals to challenge and negotiate as appropriate. 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 MI
• Promotion of VitalityCare team and proposition both internally and externally, supporting the acquisition and retention of all business
• Share knowledge and expertise within the team. Support induction and training of new VitalityCare Consultants. To include the development of training plans and material, mentoring, coaching and quality audits as appropriate
• Involvement in project and other ad hoc work as required to assist management in meeting business requirements, e.g. audits, specific projects etc
• Proactively contributing to the review, development and maintenance of VitalityCare processes, procedures and technical reference material. Identification of potential VitalityCare issues and challenges whilst seeking appropriate resolution.
• Responsibility for regularly updating own knowledge. To include (as appropriate): PREP, UKCC registration, professional qualifications, FSA regulations, company products, processes and procedures
• 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

Skills Required

Essential

• Recognised nursing or associated qualification, (Doctor, PAM RGN, SRN or ENG), or significant PMI claims experience
• Oncology nursing experience
• 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

Desirable

• Significant business knowledge or relevant external PMI experience
• Registered complaint handler (RCH accredited)
• Good working knowledge of Private Medical Insurance industry