Telephonic Case Manager I

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

Benefits offered by this job

Medical insurance (HDHP) with Pharmacy

Dental and Vision insurance

Long Term Disability

Health Savings Account and Flexible-Sp

Life Insurance

Pre-paid Legal Insurance

Parking and Transit FSA

401K and Roth 401K

Paid time off

Job summary

CorVel is seeking a Telephonic Case Manager for a fully remote role serving the Maryland area. The position requires a Bachelor’s degree with RN licensure, 3+ years of clinical experience (rehabilitation preferred), and URAC Case Management certification within 3 years if not already held.

CCM or CIRS is a plus. You will coordinate care, assess and plan patient progress, and work with payers to optimize treatment and costs.

Qualifications

• Bachelor's degree required; BSN preferred.
• 3+ years of recent clinical experience, preferably in rehabilitation.
• RN licensure in state of operation; URAC certified or to be obtained within 3 years; CCM or CIRS preferred.

Responsibilities

• Coordinate medical case management with patient, physician and providers.
• Assess, plan, implement and evaluate patient progress.
• Evaluate treatment plan for medical necessity and cost effectiveness.
• Discuss treatment plans with physician using medical and nursing knowledge.
• Make medical recommendations to payer.
• Arrange durable medical equipment and nursing services."
• Devise cost-effective care strategies.
• Prepare organized reports within set timeframes.
• Meet a minimum 95% monthly productivity.

Skills

Case management

Clinical assessment

Education

Bachelor's degree

RN degree / BSN preferred

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 timely returns to work.

Highlights

• Pay: $63,739 - $95,264/year
• Location: Remote, MD
• 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

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 and publicly traded since 1991, CorVel invests in human capital and technology to deliver innovative solutions to clients. They embrace core values of Accountability, Commitment, Excellence, Integrity, and Teamwork (ACE-IT!).