CA Telephonic Case Manager I

CorVel; California; Remote; USD 43,000 - 63,000; Full time

Benefits offered by this job

Medical (HDHP) w/Pharmacy

Dental and 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 and ROTH 401K

Paid time off

Job summary

CorVel in the United States seeks a Telephonic Case Manager to coordinate care and develop cost-effective, personalized plans for ill or injured individuals. This remote role supports timely return-to-work and collaborates with patients, physicians, and providers.

The position requires a Bachelor's degree, RN licensure, and 3+ years of clinical experience (rehabilitation preferred). URAC case management certification must be obtained within 3 years if none is held at hire.

Qualifications

• Bachelor's degree required; BSN preferred.
• 3+ years of recent clinical experience, preferably in rehabilitation.
• Current RN licensure in state of operation; URAC certification within 3 years if none held at time of hire.

Responsibilities

• Coordinate medical case management with patient, physician, and providers.
• Assess, plan, implement, and evaluate patient progress.
• Evaluate treatment plans for appropriateness, medical necessity, and cost effectiveness.
• Discuss treatment plans with physicians using nursing knowledge.
• Recommend medical plans to payer.
• Arrange durable medical equipment and nursing services.
• Develop cost-effective care strategies and organized reports.
• Meet 95% monthly productivity; follow safety rules.

Skills

Case management

Healthcare coordination

Cost containment

Clinical communication

Education

Bachelor's degree

RN nursing degree

Job description

About This Role

The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. This remote role is ideal for experienced professionals looking to support quality treatment and facilitate timely returns to work.

Highlights

• Pay: $31 - $46/hour
• Location: Remote, CA
• Department/Unit: Case Management
• Schedule: Full-time

What You'll Do

• Provide medical case management to individuals through coordination with the patient, physician, and other health care providers.
• Provide assessment, planning, implementation, and evaluation of patient's progress.
• Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness.
• Utilize medical and nursing knowledge to discuss the current treatment plan/alternate treatment plans with the physician.
• Make medical recommendations of available treatment plans to the payer.
• Implement care such as negotiating and coordinating the delivery of durable medical equipment and nursing services.
• Devise cost-effective strategies for medical care.
• Prepare organized reports within a specified timeframe.
• Meet a minimum productivity standard of 95% per month.
• Comply with all safety rules and regulations during working hours.

Requirements

• Education:
  • Bachelor's degree required, BSN preferred
  • Graduate of accredited school of nursing
• Experience:
  • 3 or more years of recent clinical experience, preferably in rehabilitation
• Licenses & Certifications:
  • Current RN Licensure in state of operation
  • URAC recognized Case Management certification required to be obtained within 3 years of hire if no nationally recognized certification is present at time of hire

Benefits

• Medical (HDHP) w/Pharmacy
• Dental and 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 and ROTH 401K
• Paid time off

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. Founded in 1987, CorVel has been publicly traded on the NASDAQ stock exchange since 1991 and is committed to delivering innovative and integrated solutions to clients while fostering a strong, supportive culture.