Job Reference: BBBH43080
Job Duration: 6 Months
Start date: ASAP
Description:
Legal, Appeals, & Retrospectives Operational Support Manager(Band 8D) (Hybrid)
£454 per day (Inside IR35)
6 Month Contract
Birmingham, West Midlands (commutable from Solihull, Coventry, Redditch, Walsall, Wolverhampton, Worcester, Tamworth)
My Client are an NHS Trust based in West Midlands and are seeking a Legal, Appeals, & Retrospectives Operational Support Manager on an initial 6 month contract basis (37.5 Hours) Paying £454 per day (Inside IR35).
The post holder will be actively involved in ensuring that service users/patients/ clients are assessed, monitored and reviewed according to national the Continuing Healthcare Framework.
The post holder will be required towork at any establishment at any time throughout the duration of their contract, normally within the location of the Organisation, or as set out under the terms of their contract
Job Summary
The post holder will be actively involved in ensuring that service users/patients/ clients are assessed, monitored and reviewed according to national the Continuing Healthcare Framework. We are committed to involving patients and the public in our work, including working with local residents to help us shape and co-produce services. All staff, particularly those involved in development or delivery of patient services, will be expected to engage appropriately with members of the public and stakeholders, including attending meetings and responding to queries as required
* The post holder will work with the local teams to deliver the vision and values of the organisation's Continuing care and Complex care contracts portfolio and pathways.
* To monitor responses to all enquiries from families, providers and solicitors regarding retrospective claims applications and/or payments in a timely manner.
* To put together Local Resolution Meeting, IRP and/or Ombudsman case files for appeals hearing.
* To monitor responses to all enquiries from families, providers and solicitors regarding retrospective claims applications and/or payments in a timely manner.
* Respond to complaints and agree next steps with the respondent
* To attend on behalf of the CCG IRP and/or Ombudsman case files for appeals hearing.
* Assist in the co-ordination of FOIs and ensure they are responded to in a timely fashion
* Chair Local Resolution Meetings and make recommendations based on evidence presented if required
* Assist in responding to complaints, member and MP queries, are responded to in a timely fashion
* To provide specialist advice with respect to the process for NHS CHC Assessment/Review for NHS Continuing Healthcare, to patients, health and social care professionals and other agencies
* Expert Clinical knowledge pertaining to Adult Continuing Healthcare and Children Continuing Healthcare applying it to individual cases.
* Provide training and staff development opportunities to clinical staff based on learning from appeals and complaints
* Any other duties commensuratewith the level of the post as requested by the Head of Service and other Team members.
* The post holder will use their clinical judgment to analyse, review and prepare retrospective/appeal cases regarding eligibility for NHS Continuing Healthcare funding.
* To produce accurate and contemporaneous reports.
* To assist the patient, carer and/or their representative to understand Continuing Healthcare policy and procedures giving explanations in understandable language demonstrating and empathetic and sensitive approach.
* To ensure the effective communication of all aspects of the process
* To liaise as appropriate with thepatient, carer and/or their representative throughout the retrospective review/appeal process, ensuring, where possible, theirinvolvement at each stage of the process.
* To be involved in the management of highly complex, contentious, and sensitive cases which may be distressing in nature for families and requiring de-escalating skills being utilised.
* To both chair and present individual cases at local resolution stage of the process.
* To Present cases at Independent Review Panels for NHS
* Promote a culture that embraces equality and strives continuously to reduce inequality in both access and outcomes for BSOL citizens.
* To maintain effective communication on issues in complex situations arising from the application of NHS Continuing Healthcare criteria and the outcomes, including a range of professionals including GP's, other health professionals and Social Care staff.
* To communicate decisions to clients and families regarding funding decisions which can include unwelcome information whereby health funding may not be approved or has been reduced or withdrawn, or a decision has been deferred for further review.* In retrospective cases, the Nurse assessor will liaise with the claimant or their representative throughout the process including final negotiation to reach agreement on entitlement to NHS Continuing Healthcare funding. To respond directly to clients and their representatives by face to face meetings, by telephone or by letter / email on panel outcomes and on queries; demonstrating the ability to communicate with sensitivity and in a way that will be understood.
* We are looking for innovative, forwardthinking, enthusiastic and confident nurses to be part of the newly structured team. Previous experience of working in NHS Continuing Healthcare is essential.
* You will be an excellent communicator with sound interpersonal skills. You will need to havethe ability to manage emotive and sensitive issues with tact and diplomacy, work well under pressure, negotiate with confidence, and maintain a high level of productivity. You will become part of a diverse multi-skilled team, who support each other with their own clinical knowledge to ensure the best personalised care for each individual client.
* You will undertake all aspectsof CHC relating to appeals and complaints in the CHC team and strive to improve processes and services for the BSOL population from learning from the outcome of appeals and complaints. You will be required to demonstrate time management skills in your ability to manage a caseload, and work in a flexible manner within a pressurized environment. You will be confident in working independently and autonomously and be able to contribute within a team.
* The post holder will be required to participate in managing our small appeals team and so previous experience of staff management is required.
* You will provide expert clinical knowledge and advice on NHS Continuing Healthcare to the wider health and social network.
* Attend, contribute and provide updatesand data to Complex Cases Senior Management Team meetings.
* Work closely with all Leads and support and work across workstreams as required.
* Attend and represent the Senior Management Team at meetings with Local Authority, Health and Social Care Professionals and Care Providers.
* Support with disputes with Local Authority colleagues and attend Dispute Panels
Education* Educated to degree level or equivalent level of experience working in a specialist area
* Dual registered sick children's nurse/Registered Nurse with a current NMC registration or equivalent
Experience
* Experience of post qualifying and continuing professional development
* Demonstrable specialist knowledge of children's continuing care and children's health provision underpinned by theory and experience.
* Experience of working with clinicians to lead and manage change
* Demonstrableknowledge of the National Framework of CHC Retrospective and Appeal processes.
* Good understanding of Continuing Healthcare Experience of working in a health environment Negotiation and conflict management skills and the ability to influence
* Previous experience of caseload management
* Knowledge of Independent Reviews panels in relation to NHS England and Improvement.
*Attending and participating in Local resolution Meeting
Industry: Public Sector and Government
Salary: £450 - £454 per day
Salary Benefits:
Vacancy Type: Contract
Job Skills: -
Contact Name: Bilal Ramay
Website: -
Direct Application URL: -