Telephonic Case Manager I

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

Benefits offered by this job

Medical insurance

Dental and Vision insurance

Long Term Disability

Health Savings Account

Flexible Spending Account

Life Insurance

401K and Roth 401K

Paid time off

Job summary

CorVel is looking for a Telephonic Case Manager to coordinate resources and develop cost-effective, personalized care plans for ill or injured individuals. This remote role supports quality treatment and timely returns to work, with a strong emphasis on cost efficiency and patient advocacy.

The position requires an RN license, a BSN is preferred, and 3+ years of clinical experience (rehabilitation preferred). Candidates must be prepared to obtain URAC or CCM/CIRS credentials as applicable.

Qualifications

• Bachelor's degree required; BSN preferred.
• Graduate of accredited school of nursing.
• 3+ years of recent clinical experience, rehab preferred.
• Current RN licensure in state of operation.
• URAC certification within 3 years if no national cert.
• CCM/CIRS certification preferred.

Responsibilities

• Provide medical case management through coordination with patients, physicians, and other healthcare providers.
• Assess, plan, implement, and evaluate patient's progress.
• Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness.
• Discuss current and alternate treatment plans with physicians using medical and nursing knowledge.
• Make medical recommendations of available treatment plans to the payer.
• Negotiate and coordinate 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.

Skills

Clinical experience

Rehabilitation

Education

Bachelor's degree

BSN

Graduate of accredited school of nursing

RN Licensure in state of operation

URAC certification within 3 years

CCM/CIRS preferred

Job description

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, FL
• Department/Unit: Case Management
• Schedule: Full-time

What You'll Do

• Provide medical case management through coordination with patients, physicians, and other healthcare providers.
• Assess, plan, implement, and evaluate patient's progress.
• Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness.
• Discuss current and alternate treatment plans with physicians using medical and nursing knowledge.
• Make medical recommendations of available treatment plans to the payer.
• Negotiate and coordinate 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

Benefits

• Medical (HDHP) w/Pharmacy
• Dental and Vision insurance
• Long Term Disability
• Health Savings Account and Flexible Spending Account Options
• Life Insurance
• Accident Insurance
• Critical Illness Insurance
• Pre-paid Legal Insurance
• Parking and Transit FSA accounts
• 401K and 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, CorVel has been publicly traded on the NASDAQ since 1991 and is committed to delivering innovative and integrated solutions to clients while fostering a strong, supportive culture.