Remote Utilization Review Case Manager I (RN)

CorVel Corporation; Folsom (CA); Remote; USD 75,000 - 95,000; Full time

Benefits offered by this job

Medical benefits

401K plan

Paid time off

Job summary

CorVel Corporation is seeking a Utilization Review Case Manager for a remote role. The ideal candidate holds an RN license and has 4+ years of clinical experience with utilization review, CPT/ICD coding knowledge, and strong communication skills.

Responsibilities include data collection, decision-making on certification, and collaboration with claims staff and stakeholders. Applicants should be adept at working in a high-volume environment, maintaining meticulous documentation, and adhering to

Qualifications

• Graduate of accredited nursing program with RN licensure in operating state.
• 4+ years of recent clinical experience with utilization review preferred.
• Knowledge of CPT/ICD coding and outpatient review preferred.

Responsibilities

• Identify necessity of review and communicate issues to claims staff.
• Collect data and analyze information to certify or deny treatment.
• Document all work in the required systems accurately.
• Promote utilization review services with stakeholders.
• Comply with safety rules including IIPP during work hours.
• Perform additional duties as assigned.

Skills

CPT/ICD coding

Interfacing with claims staff

Time management

Written and verbal communication

Teamwork and independence

Microsoft Office

Excel proficiency

Workers’ compensation knowledge

Outpatient utilization review

Education

RN license (US) or LVN/LPN per state rules

Associate’s or BSN Nursing degree

4+ years of clinical experience

Tools

Microsoft Office

Excel

Job description

CorVel Corporation is seeking a Utilization Review Case Manager for a remote role. The ideal candidate holds an RN license and has 4+ years of clinical experience with utilization review, CPT/ICD coding knowledge, and strong communication skills.

Responsibilities include data collection, decision-making on certification, and collaboration with claims staff and stakeholders. Applicants should be adept at working in a high-volume environment, maintaining meticulous documentation, and adhering to