Telephonic Case Manager I - California RN License Required

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.

California RN license is required for this 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
* 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:  $63,739 - $95,264 

A list of our benefit offerings can be found on our CorVel website: CorVel
Careers | Opportunities in Risk Management
[https://www.corvel.com/company/careers/] 

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.

#LI-Remote