CorVel Corporation · 1 day ago
UR Case Manager - Flex
Boxborough, Massachusetts, United States
Full-time
Hybrid
Mid Level
$29.95/hr - $44.77/hr
4+ years expCorVel Corporation is a national provider of industry-leading risk management solutions for various sectors. They are seeking a Utilization Review Case Manager to gather clinical information, certify medical necessity, and support the goals of the Case Management department.
InsuranceSoftware
Responsibilities
Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer
Collects data and analyzes information to make decisions regarding certification or denial of treatment
Documents all work in the appropriate manner
Promotes utilization review services with stakeholders
Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
Additional duties as assigned
Qualification
Required
Graduate of accredited school of nursing with an associate's degree, Bachelor of Science degree or Bachelor of Science in Nursing
Current Nursing licensure in the state of operation required; RN is required unless local state regulations permit LVN/LPN
4 or more years of recent clinical experience
Must have thorough knowledge of both CPT and ICD coding
Ability to interface with claims staff, attorneys, physicians and their representatives, as well as advisors/clients and coworkers
Effective organization skills in a high-volume, fast-paced environment
Strong time management skills with the ability to meet designated deadlines
Excellent written and verbal communication skills
Ability to work both independently and within a team environment
Strong interpersonal skills
Ability to utilize Microsoft Office including Excel spreadsheets
Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer
Collects data and analyzes information to make decisions regarding certification or denial of treatment
Documents all work in the appropriate manner
Promotes utilization review services with stakeholders
Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
Additional duties as assigned
Preferred
Knowledge of the workers' compensation claims process
Knowledge of outpatient utilization review
Prospective, concurrent, and retrospective utilization review experience
Experience in the clinical areas of OR, ICU, CCU, ER and/or orthopedics
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
CorVel is a nationally recognized claims management and managed care provider with over 30 years of experience in the industry.
1001-5000 employees
Funding
Current Stage
Public CompanyTotal Funding
unknown1991-07-05IPO
Leadership Team
Jeff Gurtcheff
Chief Claims Officer
Maxim Shishin
CIO
Recent News
CorVel Corp.
2025-11-04
2025-10-22
2025-10-06
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