Telephonic Case Manager I

🕒 vor 3 Tagen

🏄 California – Remote

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💵 $30 - $45 / Stunde

⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

👔 Manager

🦅 H1B-Visum-Sponsor

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👻 Geisterscore 0%

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🗣️🇺🇸🇬🇧 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

• Provide medical case management through coordination with patients, physicians, healthcare providers, employers, and referral sources • Assess, plan, implement, and evaluate patient progress • Evaluate treatment plans for appropriateness, medical necessity, and cost effectiveness • Use medical and nursing knowledge to discuss current and alternative treatment plans with physicians • Make medical recommendations to the payer • Negotiate and coordinate delivery of durable medical equipment and nursing services • Devise cost-effective medical care strategies • Prepare organized reports within specified timeframes • Maintain a minimum productivity standard of 95% per month • Comply with safety rules and regulations under the Injury and Illness Prevention Program • Perform additional duties as assigned

🎯 Anforderungen

• 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 • 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 • Ability to make independent medical decisions and recommendations • Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment • Ability to interface with claims staff, attorneys, physicians and their representatives, advisors/clients, and coworkers • Excellent written and verbal communication skills • Ability to meet designated deadlines • Computer proficiency and technical aptitude, including MS Office and Excel spreadsheets • Strong interpersonal, time management, and organizational skills • Ability to work independently and within a team environment

🏖️ 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 • 401K • ROTH 401K • Paid time off • Career advancement opportunities • Remote work

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