Remote Telephonic Case Manager II

CorVel Corporation; San Diego (CA); Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401K

Paid time off

Transit/FSA benefits

Job summary

CorVel Corporation, a national provider of managed care solutions, seeks a Telephonic Case Manager to coordinate resources and develop cost-effective, personalized care plans for ill or injured individuals.

This remote position emphasizes clinical assessment, collaboration with treating physicians, and timely return-to-work goals. You will communicate with patients, families, physicians, and adjusters while supporting cost containment and quality care.

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 not already present
• Strong clinical background in orthopedics, neurology or rehabilitation preferred
• Strong cost containment background; utilization review helpful
• CIRS or CCM certification preferred

Responsibilities

• Provide medical case management coordinating with patient, physician, employer and referral source
• Assess, plan, implement, and evaluate patient’s progress
• Evaluate treatment plan for appropriateness, medical necessity, and cost effectiveness
• Discuss current/alternate plans with physician
• Make medical recommendations to payer
• Coordinate delivery of durable medical equipment and nursing services
• Devise cost-effective strategies for medical care
• Prepare organized reports within specified timeframe
• Maintain minimum productivity standard (95% per month)
• Comply with safety rules under IIPP
• Perform additional duties as assigned

Skills

Independent medical decisions

Multitasking in high-volume env

Interface with claims staff & doctors

Written and verbal communication

Time management & organization

Teamwork and independent work

Education

RN licensure in CA

BSN or equivalent

URAC Case Management certification within 3 years

CIRS/CCM certification preferred

Tools

MS Office (Excel)

Job description

CorVel Corporation, a national provider of managed care solutions, seeks a Telephonic Case Manager to coordinate resources and develop cost-effective, personalized care plans for ill or injured individuals.

This remote position emphasizes clinical assessment, collaboration with treating physicians, and timely return-to-work goals. You will communicate with patients, families, physicians, and adjusters while supporting cost containment and quality care.