Global Case Manager - Bupa Global

Job Description: Global Case Manager - Bupa Global Victory House, Trafalgar Place, Brighton, East Sussex, BN1 4FY Full Time Permanent 40 hours per week Hybrid Working Job Grade: C15 for internals We make health happen Bupa Global is the international health insurance division of Bupa. We provide customers who want premium international coverage with products and services to access the healthcare they need anytime, around the world, whether at home or when studying, living, travelling or working abroad. Bupa Global has offices around the world including London and Brighton (UK), Dublin (Europe), Miami (USA), Dubai (UAE), Egypt and Hong Kong (China) as well as regional offices in mainland China, Singapore, the Dominican Republic, Bolivia, Panama, Guatemala and Ecuador. Role Overview The Global Case Manager is responsible for managing complex medical cases throughout the member journey, ensuring clinically appropriate, cost-effective, and member-centric outcomes. The role requires strong clinical knowledge, sound decision-making, excellent stakeholder management skills, and a commitment to delivering exceptional member experiences while supporting organizational objectives and clinical governance standards. How you’ll help us make health happen Manage complex medical cases from admission through discharge and case closure. Act as a role model for member-centric care, demonstrating kindness, empathy, and professionalism in all interactions while ensuring members receive timely, appropriate, and high-quality support throughout their healthcare journey. Review medical records, treatment plans, and supporting documentation to assess medical necessity, appropriateness of care, and policy eligibility. Liaise effectively with treating providers, members, insurers, brokers, and internal stakeholders. Coordinate care, medical evacuations, repatriations, second opinions, continuity of treatment, and discharge planning where required. Conduct clinical assessments and provide evidence-based recommendations to support case management decisions. Monitor treatment progress, hospital admissions, length of stay, and discharge planning activities. Escalate complex clinical, contractual, or policy-related issues appropriately to Medical Advisors and relevant stakeholders. Identify, assess, and mitigate clinical, operational, and financial risks associated with managed cases. Support cost-containment initiatives while maintaining appropriate clinical outcomes and member satisfaction. Ensure compliance with regulatory requirements, company policies, clinical governance frameworks, and best-practice standards. Maintain comprehensive, accurate, and timely case documentation. Lead or participate in multidisciplinary case discussions to facilitate optimal clinical outcomes. Support quality improvement initiatives, audits, service enhancements, and clinical governance activities. Manage complaints and service recovery activities related to clinical cases. Collaborate with colleagues across international markets and time zones to coordinate global healthcare delivery. Share knowledge, support team development, and contribute to a culture of continuous learning and improvement. What you'll need: Healthcare qualification (e.g., Pharmacist, Physician). Experience within case management, utilization management, healthcare administration, clinical operations, or medical insurance. Strong understanding of medical terminology, clinical pathways, and healthcare systems. Private medical insurance and/or international healthcare experience. Case management, utilization management, discharge planning, or medical assistance experience. Experience managing high-cost, high-acuity, or clinically complex cases. Experience in oncology, cardiology, intensive care, rehabilitation, mental health, or long-term care case management. Experience coordinating medical evacuations and repatriations. Knowledge of international healthcare systems and provider networks. Experience with pre-authorisation processes and medical necessity reviews. Familiarity with evidence-based clinical resources and guidelines, including: NICE NCCN UpToDate Excellent clinical assessment and decision-making abilities. Strong analytical and critical-thinking skills. Ability to interpret medical reports, treatment plans, and diagnostic investigations. Strong knowledge of medical necessity review and evidence-based healthcare. Excellent written communication, documentation, and report-writing skills. Effective verbal communication and case conferencing abilities. Negotiation and influencing capabilities when engaging with providers and insurers. Ability to prioritize workload effectively and manage multiple complex cases concurrently. Understanding of health insurance benefits, policy interpretation, and eligibility assessment. Strong customer service and member advocacy skills. Proficiency in relevant case management systems and digital platforms. Why Bupa? We’re a health insurer and provider. With no shareholders, our customers are our focus. Our people are all driven by the same purpose – helping people live longer, healthier, happier lives and making a better world. We make health happen by being brave, caring and responsible in everything we do. We encourage all of our people to “Be you at Bupa”, we champion diversity, and we understand the importance of our people representing the communities and customers we serve. That’s why we especially encourage applications from people with diverse backgrounds and experiences. Bupa takes pride in being a Level 2 Disability Confident Employer and will aim to offer an interview/assessment to disabled applicants who best meet the minimum criteria for the role. We’re committed to ensuring you’re treated fairly during the recruitment process and offer reasonable adjustments to anyone who may benefit from accommodations to the recruitment process. If you require information regarding this role in an alternative format, please email: Time Type: Full time Job Area: Delivery and Operations Locations: Victory House, Brighton