Complex Care Manager – Adults/ MH/LDANHS

Job summary

As WNL ICB prepares to delegate complex care and all age continuing healthcare to a local provider. This will be an exciting opportunity to be part of the implementation of the roles and team, that will play a major part in the ICB maintaining its statutory duties for complex care and all age continuing healthcare.

We are looking for an experienced and motivated clinical professional to join our Complex Care team as Complex Care Manager (Adults / Mental Health / Learning Disabilities & Autism).

This is a key role within the ICB, supporting the delivery of high-quality, person-centred commissioning for individuals with complex and long-term health needs. You will provide clinical expertise, assurance and operational leadership, ensuring services are delivered in line with statutory responsibilities, national frameworks and best practice.

Main duties of the job

About You

Essential Experience & Knowledge

• Registered Nurse or AHP with current professional registration
• Educated to Master's level or equivalent experience
• Strong knowledge of CHC, AACC, Section 117 and relevant legislation
• Experience in complex care / continuing care at senior level
• Experience of MDT panels, care planning, and legal/complaints processes

Skills & Attributes

• Strong clinical decision-making and judgement
• Ability to manage complex, sensitive and contentious situations
• Excellent communication, negotiation and influencing skills
• Ability to work effectively in a fast-paced, high-pressure environment
• Strong relationship-building skills across multi-disciplinary teams

Job description

Please see attached JD for full Job Description

Key Responsibilities

• Provide clinical leadership and expertise in All Age Continuing Care (AACC) and complex care
• Support and ratify CHC and Childrens Continuing Care eligibility decisions
• Manage appeals, disputes, retrospective claims and legal cases
• Lead on complaints, SARs and FOIs within the complex care portfolio
• Oversee and contribute to contract management, performance and quality assurance of delegated providers
• Work with system partners to ensure robust care planning and case management
• Develop and implement quality assurance and audit processes
• Analyse data and performance information to support service improvement
• Provide clinical advice and support to commissioning colleagues and wider teams

Key Priorities

• Ensure robust, consistent and compliant decision-making for complex care funding
• Deliver high-quality, person-centred care packages
• Strengthen provider oversight and performance management
• Improve the handling of appeals, complaints and legal processes
• Support service improvement and pathway development
• Ensure compliance with national frameworks, legislation and governance requirements

Working Relationships

You will work collaboratively across the system, including:

• ICB Nursing Directorate and Complex Care team
• Delegated provider complex care teams
• NHS England and regional quality teams
• Local Authorities
• Provider organisations and multidisciplinary teams

Strong partnership working and stakeholder engagement are central to this role.

West and North London ICB is committed to promoting equality, diversity and inclusion. We strive to ensure our workforce reflects the rich diversity of the communities we serve, and we strongly encourage applications from candidates from underrepresented groups

We recognise that a healthy work-life balance is essential to the wellbeing and productivity of our staff.

We aim to consider all flexible working requests in a fair and open way, balancing the needs of our organisation with those of our employees. By fostering a flexible working culture, we strive to create an environment where everyone can thrive and contribute to delivering high-quality services for our communities.

About us

We are NHS West and North London. We are the main commissioning NHS organisation for planning and funding health services across our area. Our job is simple: to help people stay healthy and to make sure everyone can get good care when they need it.

We bring together many health and care services across west and north London. This means we help hospitals, GPs, community services, councils and charities work better together for local people.

NHS West and North London (WNL) serves over 4.5 million people and covers 13 London boroughs. (Barnet, Brent, Camden, Ealing, Enfield, Hammersmith & Fulham, Haringey, Harrow, Hillingdon, Hounslow, Islington, Kensington & Chelsea and Westminster)

What we do

• We plan and fund local health and care services
• We support GPs, hospitals, mental health teams, community clinics and pharmacies.
• We work with councils and community groups so care is joined-up and easy to use.
• We listen to local people and use their ideas to improve services.
• We want health and care to be fair, simple and close to home.

Our strategy

• Reducing inequalities
• Investing strategically to prevent ill health
• Better supporting people with the greatest needs, so everyone stays well
• Make care more local and easier to access
• Empowered local people that feel more confident about their health and wellbeing