Remote RN Case Manager – Telephonic Care Coordination

Ultipro; Little Rock (AR); Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical benefits

401K plan

Paid time off

Job summary

CorVel is seeking a Telephonic Case Manager to coordinate resources and develop cost-effective, personalized care plans for ill or injured individuals. This remote role relies on clinical expertise to assess treatment plans and communicate with treating physicians to optimize care.

You will engage patients, families, adjusters, and providers, document progress, and ensure timely reporting. A nursing background with strong cost containment and URAC/ CCM certifications is preferred, with

Qualifications

• Graduate of accredited school of nursing.
• Current RN Licensure in state of operation.
• 3 or more years of recent clinical experience, preferably in rehabilitation.
• URAC recognized Case Management certification (ACM, CCM, CDMS, CMAC, CMC, CRC, CRRN, COHN, COHN-S, RN-BC) required to be obtained within 3 years of hire if no nationally recognized certification is present at time of hire
• Strong clinical background in orthopedics, neurology, or rehabilitation preferred
• Strong cost containment background, such as utilization review or managed care helpful
• Certification as a CIRS or CCM preferred

Responsibilities

• Coordinate medical case management with patient, physician, other health care providers, the employer, and the referral source
• Assess, planning, implementation, and evaluation of patient's progress
• Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness
• Discuss current treatment plans/alternate plans with the physician
• Make medical recommendations of available treatment plans to the payer
• Coordinate delivery of durable medical equipment and nursing services
• Devise cost-effective strategies for medical care
• Prepare organized reports within a specified timeframe
• Minimum Productivity Standard is 95% per month
• Additional duties as assigned

Skills

Independent medical decisions

Multi-tasking

Interfacing with claims staff

Written/verbal communication

Deadlines

MS Office proficiency

Team-oriented

Independent work

Education

Graduate of accredited school of nursing

RN licensure in state of operation

3+ years clinical experience

URAC case management certification (within 3 years if none)

Orthopedics/Neurology background

Cost containment background

CCM/CIRS certification preferred

Tools

MS Office

Excel

Job description

CorVel is seeking a Telephonic Case Manager to coordinate resources and develop cost-effective, personalized care plans for ill or injured individuals. This remote role relies on clinical expertise to assess treatment plans and communicate with treating physicians to optimize care.

You will engage patients, families, adjusters, and providers, document progress, and ensure timely reporting. A nursing background with strong cost containment and URAC/ CCM certifications is preferred, with