Remote RN Case Manager – Rehab & Cost-Containment

CorVel Corporation; Little Rock (AR); Hybrid; USD 65,000 - 90,000; Full time

Job summary

CorVel is seeking a Telephonic Case Manager to coordinate resources and develop cost-effective, personalized care plans for ill or injured individuals. The role emphasizes clinical judgment to assess treatment plans and supports timely return to work, communicating with treating physicians and patients, families, and adjusters.

The position is remote and requires RN licensure and several years of clinical experience, with URAC case management certification preferred or to be obtained within 3

Qualifications

• Graduate of accredited school of nursing.
• Current RN licensure in state of operation.
• 3+ years of recent clinical experience, preferably in rehabilitation.
• URAC recognized Case Management certification required within 3 years of hire if no nationally recognized certification is present at time of hire.
• Strong clinical background in orthotics, neurology, or rehabilitation preferred.
• Strong cost containment background, such as utilization review or managed care helpful.
• Certification as a CIRS or CCM preferred.

Responsibilities

• Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source.
• 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.
• Devis[e] cost-effective strategies for medical care.
• Required to prepare organized reports within a specified timeframe.
• Minimum Productivity Standard is 95% per month.
• Additional duties asassigned

Skills

Independent medical decisions

Multi-tasking

Stakeholder interfacing

Written communication

Time management

MS Office

Interpersonal skills

Teamwork

Education

Registered Nurse licensure (RN)

URAC case management certification

CIRS/CCM certification preferred

Tools

MS Office

Job description

CorVel is seeking a Telephonic Case Manager to coordinate resources and develop cost-effective, personalized care plans for ill or injured individuals. The role emphasizes clinical judgment to assess treatment plans and supports timely return to work, communicating with treating physicians and patients, families, and adjusters.

The position is remote and requires RN licensure and several years of clinical experience, with URAC case management certification preferred or to be obtained within 3