LD Complex Cases Manager

Are you a dedicated and compassionate registered nurse with experience in learning disabilities? Join our Coventry & Warwickshire ICB team as a Complex Case Manager, where you will play a crucial role in the day-to-day clinical and operational management of a diverse caseload.

Your responsibilities will include assessment and case management of patients funded by Continuing Healthcare (CHC), S117, Mental Health, and Learning Disabilities. Additionally, you will contribute to targeted clinical reviews within the Clinical Assessment & Placement Service for Coventry & Rugby.

• Lead and manage Clinical Healthcare Assessors, ensuring the Clinical Assessment team operates effectively and achieves outstanding patient care.

• Participate in the recruitment process for members of the CHC Team.

• Conduct peer reviews for clinical staff and facilitate access to necessary training and personal development opportunities.

• Ensure compliance with all appropriate legislation and guidance, such as the Mental Capacity Act, The Human Rights Act, and Safeguarding Adults and Children Legislation.

• Provide professional support, expertise, and input to the Placement Team and ratification Panels.

• Develop short, medium, and long-term business plans to achieve quality outcomes.

• Actively participate in audits conducted by the Head of Joint Care Home Contracting & Procurement and Clinical Operational Leads.

• Conduct assessments, case management, monitoring, and formal reviews of patients funded by CRCCG / WNCCG and those with health-funded needs, including NHS Continuing Healthcare, S117, MH, or Learning Disabilities.

• Lead MDTs through the CHC assessment and decision-making process, referring completed assessments to the NHS CHC Panel when appropriate.

• Complete initial determinations and reviews in accordance with Funded Nursing Care (FNC) legislation.

• Provide health advice and expertise to Health and Social Care staff.

• Case manage your own clinical caseload, ensuring prompt resolution of funding, placement, invoice, and complaint-related issues.

• Chair funding panels, Best Interest meetings, and Clinical Treatment Reviews as required.

• Manage referrals that are fast-tracked through the CHC process for patients with rapidly deteriorating conditions.

• Ensure CHC reviews follow National guidance and take responsibility for managing and reviewing complex cases.

• Prepare and manage appeal cases for current appeals and restitution cases for Independent Review Panels, related to funding requests and NHS Continuing Healthcare criteria.

• Empower team members to understand their contributions to the provided services and view development as an opportunity for personal growth.

• Project a positive image of the Clinical Assessment Team internally and externally.

• Recognize and communicate team and individual achievements.

• Provide mentorship and support to staff, addressing issues, and assisting with their professional development.

• Collaborate with colleagues in Health and Social Care to ensure appropriate understanding and application of Health funding eligibility criteria, providing necessary training and advice.

• Maintain effective communication and liaison with patients, other agencies, relatives, and carers.

• Be knowledgeable about relevant legislation and professional codes influencing care delivery to patients in nursing home care.

• Work with colleagues in contracting and Placement Teams to achieve best value for individual care packages.

• Assist in making appropriate bids for resources and ensure accurate recording of costs and changes in packages on the patient management system.

• Adhere to the Equal Opportunities and Diversity Policy and promote principles of equality and diversity in your daily work.

• Pursue relevant programs of personal and professional development.

• Maintain current registration of appropriate qualifications with the NMC and keep a portfolio demonstrating personal professional development.

• Act in accordance with the Code of Conduct for NHS Managers and relevant legislation and organizational policies.

• Demonstrate a strong commitment to safeguarding vulnerable adults and children, knowing how to report concerns and access relevant training.

Become part of our passionate team and make a positive impact on the lives of vulnerable individuals with learning disabilities. Your role as a Complex Case Manager will be essential in ensuring exceptional care and support for our patients, fostering a culture of continuous improvement and collaborative work.