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CorVel Corporation · 4 weeks ago

Telephonic Case Manager I - RN

United States

Full-time

Remote

Mid Level

$62K/yr - $93K/yr

3+ years exp

CorVel Corporation is a national provider of risk management solutions, and they are seeking a Telephonic Case Manager RN to coordinate resources and develop personalized care plans for ill or injured individuals. This role involves using clinical expertise to assess treatment plans and communicate with healthcare providers to ensure quality care and timely return to work.

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

RN LicensureCase Management CertificationClinical ExperienceMedical Decision MakingComputer ProficiencyMulti-tasking SkillsEffective CommunicationInterpersonal SkillsTime ManagementOrganizational Skills

Required

RN license

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