Telephonic Case Manager I

🕒 il y a 4 jours

🏄 California – Distant

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💵 $30 - $45 / heure

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

🦅 Parrain de Visa H1B

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👻 Score fantôme 0%

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🗣️🇺🇸🇬🇧 Anglais requis

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Logo of CorVel Corporation

CorVel Corporation

1001 - 5000 employés

Fondée en 1987

🏥 Santé

💼 Conseil

📦 Logistique

Healthcare • Consulting • Logistics

CorVel Corporation est une entreprise de gestion des risques et de services de santé qui propose des solutions intégrées de gestion des réclamations et de soins pour les payeurs et les employeurs. Elle se spécialise dans la gestion des indemnisations des travailleurs, la gestion des responsabilités et des incapacités, les réseaux de prestataires et de pharmacies, ainsi que les solutions de risques alternatifs. Elle offre des plateformes technologiques utilisant l'IA et l'analyse de données pour simplifier l'administration des réclamations, améliorer les résultats et réduire les coûts.

Description

• 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

🎯 Exigences

• 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

🏖️ Avantages

• 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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