Telephonic Case Manager I

🔥 2 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $30 - $45 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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CorVel Corporation

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1987

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

CorVel Corporation is a risk management and healthcare services company that provides integrated claims and care solutions for payors and employers. It specializes in workers' compensation, liability and disability management, provider and pharmacy networks, and alternative risk solutions, and it offers technology platforms that use AI and data analytics to streamline claims administration, improve outcomes, and reduce costs.

📋 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

🎯 Requirements

• 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

🏖️ Benefits

• 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