Telephonic Case Manager I

CorVel; Arkansas; Remote; USD 64,000 - 95,000; Full time

Benefits offered by this job

HDHP Medical

Dental

Vision

Long Term Disability

Health Savings Account

Flexible Spending Account

Life Insurance

Accident Insurance

Critical Illness Insurance

Pre-paid Legal Insurance

Parking and Transit FSA

401K

Paid time off

Job summary

CorVel invites applications for a Telephonic Case Manager. This remote role coordinates care plans, works with patients, physicians, and providers to ensure effective, cost-conscious treatment, and helps patients return to work promptly.

Requirements include a Bachelor's degree with RN licensure, URAC certification within 3 years of hire if none, and 3+ years of clinical experience (rehabilitation preferred). CCM/CIRS a plus.

Qualifications

• Bachelor's degree required; BSN preferred.
• Graduate of accredited school of nursing.
• 3+ years of recent clinical experience, preferably in rehabilitation.
• RN licensure in state of operation; URAC certification within 3 years if none at hire.
• CCM or CIRS certification preferred.

Responsibilities

• Provide medical case management coordinating with patient, physician and providers.
• Assess, plan, implement, and evaluate patient progress.
• Evaluate treatment plan for appropriateness, medical necessity and cost effectiveness.
• Discuss current/alternate plans with physician and make recommendations to payer.
• Coordinate delivery of durable medical equipment and nursing services.
• Devise cost-effective strategies for medical care and report within set timelines.
• Meet a minimum productivity standard of 95% per month.

Skills

Medical case management

Nursing knowledge

Clinical assessment

Coordination with physicians

Education

Bachelor's degree

BSN preferred

Graduate of accredited nursing program

Job description

About This Role

The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. This remote role is ideal for experienced professionals looking to support quality treatment and facilitate timely returns to work.

Highlights

• Pay: $63,739 - $95,264/year
• Location: Remote, AR
• Department/Unit: Case Management
• Schedule: Full-time

What You'll Do

• Provide medical case management to individuals through coordination with the patient, physician, and other health care providers.
• 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.
• Devise cost-effective strategies for medical care.
• Prepare organized reports within a specified timeframe.
• Meet a minimum productivity standard of 95% per month.
• Perform additional duties as assigned.

Requirements

Education

• Bachelor's degree required, BSN preferred
• Graduate of accredited school of nursing

Experience

• 3 or more years of recent clinical experience, preferably in rehabilitation

Licenses & Certifications

• Current RN Licensure in state of operation
• URAC recognized Case Management certification required to be obtained within 3 years of hire if no nationally recognized certification is present at time of hire
• Certification as a CIRS or CCM preferred
• FL/PA Workers Compensation case management experience preferred

Benefits

• 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
• Paid time off

About CorVel

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. Founded in 1987 and publicly traded since 1991, CorVel is committed to delivering innovative and integrated solutions to clients while fostering a strong, supportive culture and career advancement opportunities.