CA Medical Case Manager I - RN

CorVel Corporation; Folsom (CA); Hybrid; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a compassionate and self-motivated registered nurse for a Medical Case Manager role. This position offers a unique opportunity to make a significant impact on the lives of injured workers and their families. You will work both from home and on the road, ensuring that patients receive the best care possible through effective communication and collaboration with healthcare providers. The ideal candidate will possess strong organizational skills and a clinical background, enabling them to evaluate treatment plans and facilitate recovery. Join this supportive and innovative company that values your contributions and provides ample career advancement opportunities.

Qualifications

• Must be a graduate of an accredited nursing school with current RN licensure.
• Experience as a Medical Case Manager or clinical background in orthopedics is preferred.

Responsibilities

• Provide Medical Case Management through in-person and telephonic communications.
• Evaluate treatment plans for appropriateness and cost-effectiveness.
• Attend hospital discharge planning conferences and negotiate care delivery.

Skills

Effective communication

Multi-tasking

Interpersonal skills

Time management

Organizational skills

Computer proficiency

Technical aptitude

Education

Graduate of accredited school of nursing

Current RN Licensure

Certification as a CCM, CIRS, or other Case Management certifications

Tools

MS Office

Excel spreadsheets

Job description

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Folsom, CA.

Work from home, and on the road. Monday – Friday, regular business hours.

As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and their families. Your responsibilities include working closely with injured workers to facilitate their recovery. You will work collaboratively with the patient, their family, medical providers, members of our team, and others. This is a heavy local travel role responsible for working with a caseload of workers compensation injured workers within a defined jurisdiction.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

• Provides Medical Case Management to individuals through in person and telephonic communications with the patient, physician, other health care providers, employer and others.
• Utilizes their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans.
• Evaluates patient’s treatment plan for appropriateness, medical necessity, and cost effectiveness.
• Provides assessment, planning, implementation and evaluation of patient’s progress.
• Attends doctors, other providers, home and in some cases, attorney’s visits.
• Attends hospital and/or long-term facility discharge planning conferences for the purpose of determining appropriateness of care and developing an effective long-term care strategy. Initial home visit for initial evaluation.
• Implements care such as negotiating the delivery of durable medical equipment and nursing services.
• This role requires regular travel, dependent on the injured worker’s injuries and needs. The employee must be available for local travel up to approximately 60% of the work week/month.
• This role may require overnight travel.

KNOWLEDGE & SKILLS:

• Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment.
• Experience as a RN, Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred.
• Ability to meet with the patient, their physicians, other healthcare providers, attorneys, and advisors/clients and coworkers.
• A cost containment background, such as utilization review or managed care is helpful.
• Strong interpersonal, time management and organizational skills.
• Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets.
• Ability to work both independently and within a team environment.

EDUCATION & EXPERIENCE:

• Graduate of accredited school of nursing.
• Current RN Licensure in state of operation.
• Certification as a CCM, CIRS, or other Case Management certifications are preferred.
• A valid driver’s license, reliable transportation, and ability to travel to assigned locations is required.

ABOUT CORVEL:

CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.