Utilization Review Case Manager I

🕒 Outubro 16

🏄 California – Remoto

🏄 California – Remote

💵 $30 - $45 / hora

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

🦅 Patrocina Visto H1B

Esta empresa já patrocinou vistos H1B no passado.

👻 Score fantasma 3%

O que significa: a chance de ninguém estar realmente contratando para esta vaga.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Por que essa pontuação:

• Aberta há 26 dias.
• As vagas desta empresa costumam ser preenchidas em 21 dias.

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CorVel Corporation

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 1987

🏥 Saúde

💼 Consultoria

📦 Logística

Healthcare • Consulting • Logistics

A CorVel Corporation é uma empresa de gestão de riscos e serviços de saúde que fornece soluções integradas de sinistros e cuidados para pagadores e empregadores. Especializa-se em gestão de compensação de trabalhadores, responsabilidade civil e invalidez, redes de provedores e farmácias, e soluções alternativas de risco, além de oferecer plataformas tecnológicas que utilizam IA e análise de dados para agilizar a administração de sinistros, melhorar resultados e reduzir custos.

Descrição

• Gather demographic and clinical information on prospective, concurrent, and retrospective inpatient admissions and outpatient treatment • Certify medical necessity and assign an appropriate length of stay • Support the goals of the Case Management department and CorVel • Identify the necessity of the review process • Communicate issues of concern to appropriate claims staff and customers • Collect data and analyze information to make certification or denial decisions regarding treatment • Document all work appropriately • Promote utilization review services with stakeholders • Comply with safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program • Perform additional duties as assigned

🎯 Requisitos

• Graduate of an 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 required unless local state regulations permit LVN/LPN • 4 or more years of recent clinical experience • Thorough knowledge of CPT and ICD coding • Ability to interface with claims staff, attorneys, physicians and their representatives, advisors/clients, and coworkers • Effective organization skills in a high-volume, fast-paced environment • Strong time management skills and ability to meet designated deadlines • Excellent written and verbal communication skills • Ability to work independently and within a team environment • Strong interpersonal skills • Ability to utilize Microsoft Office, including Excel spreadsheets • Knowledge of the workers’ compensation claims process preferred • Knowledge of outpatient utilization review preferred • Prospective, concurrent, and retrospective utilization review experience preferred • Clinical experience in OR, ICU, CCU, ER, and/or orthopedics preferred

🏖️ Benefícios

• Medical (HDHP) with Pharmacy • Dental insurance • Vision insurance • 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 • Career advancement opportunities • Remote work

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