Telephonic Case Manager I jobs in United States
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CorVel Corporation · 3 months ago

Telephonic Case Manager I

CorVel Corporation is a national provider of risk management solutions, and they are seeking a Telephonic Case Manager I to coordinate resources and develop personalized care plans for ill or injured individuals. The role involves assessing treatment plans, communicating with healthcare providers, and ensuring quality treatment and timely return to work for patients.

InsuranceSoftware

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

Qualification

Current RN LicensureCase Management certificationClinical experienceMedical decision makingComputer proficiencyEffective multi-taskingCommunicationTime managementInterpersonal skillsTeamwork

Required

Bachelor's degree required
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

Preferred

BSN preferred
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

Benefits

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
Paid time off

Company

CorVel Corporation

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CorVel is a nationally recognized claims management and managed care provider with over 30 years of experience in the industry.

Funding

Current Stage
Public Company
Total Funding
unknown
1991-07-05IPO

Leadership Team

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Jeff Gurtcheff
Chief Claims Officer
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Maxim Shishin
CIO
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Company data provided by crunchbase