The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals, utilizing clinical expertise to assess treatment plans and communicate with physicians. Responsibilities include providing medical case management, evaluating treatment appropriateness, implementing care coordination, and devising cost-effective medical strategies.
Requirements summary
Candidates must have a Bachelor's degree (BSN preferred) and be a graduate of an accredited school of nursing with current RN licensure in the state of operation, along with three or more years of recent clinical experience, preferably in rehabilitation. A nationally recognized Case Management certification must be obtained within three years of hire if not already possessed.
The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals.
The goal is to support quality treatment and, when appropriate, a timely return to work.
This role uses clinical expertise to assess the appropriateness of current treatment plans based on the patient’s medical and physical condition.
The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options when needed.
They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel.
This is a remote role.
Essential functions & responsibilities
Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source
Provide assessment, planning, implementation, and evaluation of patient's progress
Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness
Utilize medical and nursing knowledge to discuss the current treatment plan/alternate treatment plans with the physician
Make medical recommendations of available treatment plans to the payer
Implement care such as negotiating and coordinating the delivery of durable medical equipment and nursing services
Devise cost-effective strategies for medical care
Required to prepare organized reports within a specified timeframe
Minimum Productivity Standard is 95% per month
Additional duties as assigned
Knowledge & skills
Ability to make independent medical decisions and recommendations to all parties
Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment
Ability to interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers
Excellent written and verbal communication skills
Benefits
Accident Insurance
Critical Illness Insurance
Dental Insurance
Life Insurance
Paid Time Off
Vision Insurance
Medical Insurance
Health Savings Account
401k
Long Term Disability
Flexible Spending Account Options
Roth 401k
Pre-paid Legal Insurance
Parking And Transit FSA Accounts
Ability to meet designated deadlines
Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets
Strong interpersonal, time management, and organizational skills
Ability to work both independently and within a team environment
Education & experience
Bachelor’s degree required, BSN preferred
Graduate of accredited school of nursing
Current RN Licensure in state of operation
3 or more years of recent clinical experience, preferably in rehabilitation
URAC recognized Case Management certification (ACM, CCM, CDMS, CMAC, CMC, CRC, CRRN, COHN, COHN-S, RN-BC) required to be obtained within 3 years of hire if no nationally recognized certification is present at time of hire
Strong clinical background in orthopedics, neurology, or rehabilitation preferred
Strong cost containment background, such as utilization review or managed care helpful
Certification as a CIRS or CCM preferred
Pay range
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range
$66,941 - $101,258
A list of our benefit offerings can be found on our CorVel website
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
About corvel
CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.
CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991.
Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients.
We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.
Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
