Case Manager II

🕒 vor 1 Monat

🏄 California – Remote

infoinfo

💵 $32 - $48 / Stunde

⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

👔 Manager

🦅 H1B-Visum-Sponsor

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👻 Geisterscore 9%

infoinfo

🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of CorVel Corporation

CorVel Corporation

1001 - 5000 Mitarbeiter

Gegründet 1987

🏥 Gesundheitswesen

💼 Beratung

📦 Logistik

Healthcare • Consulting • Logistics

Die CorVel Corporation ist ein Unternehmen für Risikomanagement und Gesundheitsdienstleistungen, das integrierte Schadenmanagement- und Pflege-Lösungen für Kostenträger und Arbeitgeber anbietet. Es spezialisiert sich auf Arbeitsunfallmanagement, Haftungs- und Invaliditätsmanagement, Anbieter- und Apothekennetzwerke sowie alternative Risikolösungen. Zudem bietet es Technologieplattformen, die KI und Datenanalysen nutzen, um die Schadenverwaltung zu optimieren, Ergebnisse zu verbessern und Kosten zu senken.

Beschreibung

• 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 • Document all work appropriately • Promote utilization review services with stakeholders • Comply with safety rules and regulations during work hours under the Injury and Illness Prevention Program • Perform additional duties as assigned

🎯 Anforderungen

• 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

🏖️ Vorteile

• 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 • 401(k) • Roth 401(k) • Paid time off • Career advancement opportunities • Supportive culture

Jetzt Bewerben

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