CA Medical Case Manager II

CorVel Corporation; San Diego (CA); On-site; USD 90,000 - 115,000; Full time

Job summary

CorVel Corporation in San Diego, CA is seeking a registered nurse to fill a Medical Case Manager role. You will travel locally to support injured workers and coordinate care.

The role emphasizes collaboration with patients, families, providers, and the team to facilitate recovery, assess progress, and ensure appropriate, cost-effective treatment plans. Candidates should have RN licensure, a clinical background in orthopedics/rehabilitation, and CCM/CIRS certification; travel up to 60% may be

Qualifications

• RN with current state licensure and nursing degree.
• Experience as an RN Case Manager or in orthopedics/rehabilitation preferred.
• CCM/CIRS certification is preferred.

Responsibilities

• Provide in-person and telephonic Medical Case Management with patient, physician and providers.
• Discuss treatment plans and alternatives with physicians.
• Assess, plan, implement and evaluate patient progress.
• Ensure medical necessity and cost-effectiveness of plans.
• Attend doctors' visits and discharge planning conferences.
• Conduct home visits and coordinate DME and nursing services.
• Travel locally up to 60% of the time; overnight travel may be required.
• Adhere to safety policies (IIPP) and perform additional duties as needed.

Skills

Effective communication

Multi-tasking

Team collaboration

Interpersonal skills

Time management

Microsoft Office

Independent worker

Education

RN licensure

CCM/CIRS certification

Nursing degree

Tools

Microsoft Office Suite

EMR systems

Data entry

Job description

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in San Diego, 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 in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers,the employer, andthe referral source
• Utilizestheir medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans
• Provides assessment, planning, implementation, and evaluation of patient’s progress
• Evaluates patient’s treatment plan for appropriateness, medical necessity, and cost effectiveness
• Attends doctors, other providers, home and in some cases, attorney’s visits
• Attends hospital and/or long-term facility discharge planning conferences, etc. for the purpose of determining appropriateness of care and developing an effective long-term care strategy
• Conducts 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
• Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program(“IIPP”)
• Additional duties as required

KNOWLEDGE & SKILLS:

• Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment
• Ability to meet with the patient, their physicians, other healthcare providers, attorneys, 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 utilizeMicrosoftOffice, including Excel spreadsheets
• Ability to work both independently and within a team environment

EDUCATION & EXPERIENCE:

• Experience as an RN Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred
• Graduate of accredited school of nursing
• Current RN Licensure in state of operation
• Certification as a CCM, CIRS, or other Case Management certifications preferred
• A valid driver’s license, reliable transportation, and ability to travel to assigned locations is required

PAY RANGE

CorVel uses a market-based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range, and these adjustments would be clarified during the offer process.

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL– Medical Case Managers:

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. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes:

• Medical (HDHP) w/Pharmacy
• Dental
• Vision
• 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

In addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel’s proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur.

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

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Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.