About this role
Job summary
We're looking for a Clinical Case Manager - Pre-Authorisation to join our Case Management team. This opportunity is ideally suited to an experienced Band 6 nurse or healthcare professional with extensive inpatient bedside nursing experience across both adult and paediatric care, or a senior nurse with a strong background within the healthcare insurance sector. You'll bring the confidence to make complex clinical decisions, challenge where appropriate, and work collaboratively with consultants, nursing teams, insurers and operational stakeholders to ensure patients receive safe, timely and cost-effective care throughout their healthcare journey.
As a Clinical Case Manager, you'll use your clinical expertise to assess pre-authorisation requests for complex treatments including chemotherapy, radiotherapy and bone marrow transplant cases, ensuring all reviews are completed in line with national standards, evidence-based practice and contractual requirements. Working collaboratively across multidisciplinary teams, you'll influence patient care pathways, provide clinical guidance to non-clinical colleagues and help drive quality, efficiency and patient satisfaction.
Main duties of the job
Manage pre-authorisation requests for complex treatments and ensure timely completion in line with contractual requirements.
Conduct clinical reviews using nationally recognised, evidence-based standards and escalate cases where appropriate.
Assess medical necessity and level of care requirements, making recommendations to Physicians and Medical Directors.
Collaborate with clinical teams, provider networks and third-party payors to coordinate patient treatment plans and authorisations.
Maintain accurate clinical documentation, support audit activity and contribute to quality improvement initiatives.
About us
Why HCA UK?
Originally founded over 50 years ago by Dr Thomas Frist, HCA has gone on to become one of the worlds leading healthcare providers. In the UK, were one of the largest providers of privately funded healthcare and have invested over £500 million in the latest treatments, technology, techniques, medication and facilities. Being part of a large multisite, established healthcare group we can offer you unrivalled opportunities for career progression through internal and external courses, as well as working conditions that prioritise both your mental and physical wellbeing.
By caring for our colleagues, we empower them to provide exceptional care for our patients. Thats why we offer a host of flexible benefits that reflect the invaluable contribution they make every day. As a Clinical Case Manager - Pre-Authorisation youll be eligible for:
25 days holiday each year, plus bank holidays, increasing with service, with option to buy or sell leave to suit you
Private Healthcare Insurance for treatment at our leading hospitals
Private pension contribution which increases with length of service
Season Ticket Loan and Cycle to Work scheme
Group Life Assurance from day one
Critical illness cover
Enhanced Maternity and Paternity pay
Corporate staff discount for all facilities including Maternity packages at The Portland
Comprehensive range of flexible health, protection and lifestyle benefits to suit you
Discounts with over 800 major retailers
Job description Job responsibilities
Clinical Case Manager - Pre-Authorisation
Location: Leaders in Oncology Care, London
This role is based fully on site
Full time, 37.5 hours per week
Monday to Friday, with a choice of 8am4pm or 9am5pm
Permanent contract
Salary: Competitive
We're looking for a Clinical Case Manager - Pre-Authorisation to join our Case Management team. This opportunity is ideally suited to an experienced Band 6 nurse or healthcare professional with extensive inpatient bedside nursing experience across both adult and paediatric care, or a senior nurse with a strong background within the healthcare insurance sector. You'll bring the confidence to make complex clinical decisions, challenge where appropriate, and work collaboratively with consultants, nursing teams, insurers and operational stakeholders to ensure patients receive safe, timely and cost-effective care throughout their healthcare journey.
As a Clinical Case Manager, you'll use your clinical expertise to assess pre-authorisation requests for complex treatments including chemotherapy, radiotherapy and bone marrow transplant cases, ensuring all reviews are completed in line with national standards, evidence-based practice and contractual requirements. Working collaboratively across multidisciplinary teams, you'll influence patient care pathways, provide clinical guidance to non-clinical colleagues and help drive quality, efficiency and patient satisfaction.
Above all else, were committed to the care and improvement of human life. Its this guiding vision that influences everything we do at HCA UK. From the CEO to the colleagues on the floor we all have a part to play in delivering exceptional care to our patients. Others may think this is just a role in Case Management, but to us, youll be part of a wider team with a unique sense of purpose, one that helps improve lives on a daily basis.
What youll do:
Manage pre-authorisation requests for complex treatments and ensure timely completion in line with contractual requirements.
Conduct clinical reviews using nationally recognised, evidence-based standards and escalate cases where appropriate.
Assess medical necessity and level of care requirements, making recommendations to Physicians and Medical Directors.
Collaborate with clinical teams, provider networks and third-party payors to coordinate patient treatment plans and authorisations.
Maintain accurate clinical documentation, support audit activity and contribute to quality improvement initiatives.
What youll bring:
Registered with the NMC as an Adult Nurse, with substantial post-registration experience and demonstrable exposure to paediatric care.
Due to the specialist oncology nature of this role, candidates must hold a current Systemic Anti-Cancer Therapy, SACT,Passport. Applications from candidates without this qualification cannot be considered.
Extensive inpatient bedside nursing experience across both adult and paediatric services. Candidates must have hands-on clinical experience in both settings, not one or the other.
Strong background in inpatient nursing or insurance sector in a clinical case management or utilisation review capacity.
Senior-level clinical experience, typically at Band 6 or above, with demonstrable clinical leadership, service coordination, team supervision and/or management responsibilities.
Proven ability to lead complex clinical decision-making, influence multidisciplinary teams and coordinate care across multiple stakeholders.
Excellent verbal and written communication skills with the ability to build effective relationships across clinical, operational and insurer stakeholders
Why HCA UK?
Originally founded over 50 years ago by Dr Thomas Frist, HCA has gone on to become one of the worlds leading healthcare providers. In the UK, were one of the largest providers of privately funded healthcare and have invested over £500 million in the latest treatments, technology, techniques, medication and facilities. Being part of a large multisite, established healthcare group we can offer you unrivalled opportunities for career progression through internal and external courses, as well as working conditions that prioritise both your mental and physical wellbeing.
By caring for our colleagues, we empower them to provide exceptional care for our patients. Thats why we offer a host of flexible benefits that reflect the invaluable contribution they make every day. As a Clinical Case Manager - Pre-Authorisation youll be eligible for:
25 days holiday each year, plus bank holidays increasing with service, with option to buy or sell leave to suit you
Private Healthcare Insurance for treatment at our leading hospitals
Private pension contribution which increases with length of service
Season Ticket Loan and Cycle to Work scheme
Group Life Assurance from day one
Critical illness cover
Enhanced Maternity and Paternity pay
Corporate staff discount for all facilities including Maternity packages at The Portland
Comprehensive range of flexible health, protection and lifestyle benefits to suit you
Discounts with over 800 major retailers
Culture and values
At HCA UK we believe exceptional care starts with our people. We celebrate the unique perspectives and different experiences each of us bring as we know that when you feel seen, heard and supported you can be at your best for our patients, and each other.
Our mission is simple, above all else were committed to the care and improvement of human life, a clear statement that extends to both our patients and colleagues. To achieve this, we live and breathe four core values:
Unique and Individual: We recognise and value everyone as unique and individual
Kindness and compassion: We treat people with kindness and compassion
Honesty, integrity and fairness: We act with absolute honesty, integrity and fairness
Loyalty, respect and dignity: We trust and treat one another as valued members of the HCA UK family with loyalty, respect and dignity
Reasonable adjustments
We believe everyone should feel comfortable to bring their full self to work and be afforded the same opportunities. As a Disability Confident committed organisation, were happy to discuss flexible working arrangements to suit your needs as well as offer reasonable adjustments throughout our recruitment process, and in the workplace, to anyone that needs them.
Person Specification
Qualifications Essential
Registered with the NMC as an Adult Nurse, with substantial post-registration experience and demonstrable exposure to paediatric care. Due to the specialist oncology nature of this role, candidates must hold a current Systemic Anti-Cancer Therapy, SACT Passport. Applications from candidates without this qualification cannot be considered. Extensive inpatient bedside nursing experience across both adult and paediatric services. Candidates must have hands-on clinical experience in both settings, not one or the other. Strong background in inpatient nursing or insurance sector in a clinical case management or utilisation review capacity. Senior-level clinical experience, typically at Band 6 or above, with demonstrable clinical leadership, service coordination, team supervision and/or management responsibilities. Proven ability to lead complex clinical decision-making, influence multidisciplinary teams and coordinate care across multiple stakeholders. Excellent verbal and written communication skills with the ability to build effective relationships across clinical, operational and insurer stakeholders
Disclosure and Barring Service Check This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
UK Registration
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).
Employer details Employer name HCA Healthcare UK
Address Leaders in Oncology Care
95-97 Harley Street
London
W1G 6AF
United Kingdom
Employer's website https://www.hcahealthcare.co.uk/ (Opens in a new tab)