Medical Case Management Manager

CorVel Corporation; Athens (GA); Hybrid; USD 60,000 - 90,000; Full time

Benefits offered by this job

HDHP medical

Dental

Vision

Long-term disability

Health Savings Account (HSA)

Flexible Spending Account (FSA)

Life insurance

Accident insurance

Critical illness insurance

Pre-paid legal insurance

Parking and transit benefits

401K

ROTH 401K

Paid time off

Job summary

CorVel Corporation is seeking a dedicated registered nurse for a Medical Case Manager role covering Newnan, Columbus, LaGrange, Fayetteville, Stockbridge and Metro Atlanta. This position includes work from home options and local travel with regular business hours Monday–Friday.

The role involves coordinating care for workers’ compensation cases, collaborating with patients, families, providers and employers, and ensuring effective, cost-conscious care plans while maintaining RN licensure and

Qualifications

• Active RN licensure in state of operation (GA) is required.
• Certification as CCM/CIRS preferred.
• Graduate of an accredited school of nursing.

Responsibilities

• Provide in-person and telephonic medical case management.
• Discuss treatment plans with physicians and discuss alternatives.
• Assess, plan, implement and evaluate patient progress.
• Evaluate treatment plans for medical necessity and cost effectiveness.
• Travel locally up to ~60% of the time and may include overnight trips.

Skills

Interpersonal skills

Time management

Organizational skills

Computer literacy

Microsoft Office

Education

RN licensure (GA)

CCM/CIRS certification preferred

Tools

Microsoft Office

Job description

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in the following areas of Georgia: Newnan, Columbus, LaGrange, Fayetteville, Stockbridge, Metro ATL, South of Atlanta. 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. 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.

• Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer, and the referral source
• Utilizes their 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 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
• 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
• 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 utilize Microsoft Office, including Excel spreadsheets
• 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 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. A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

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. 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, and 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.