Telephonic Case Manager I

CorVel; New York (NY); Remote; USD 64,000 - 95,000; Full time

Benefits offered by this job

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 and ROTH 401K

Paid time off

Job summary

CorVel is seeking a Telephonic Case Manager for a remote role in New York. You will coordinate care plans, assess and adjust treatments, and communicate with patients and providers to ensure cost-effective, high-quality care.

The ideal candidate has an RN license, a Bachelor's degree, and 3+ years of relevant clinical experience, preferably in rehabilitation. Certification in URAC CCM or CCM/CIRS is preferred or to be obtained within 3 years of hire.

Qualifications

• Bachelor's degree required; BSN preferred.
• Graduate of accredited school of nursing.
• 3+ years of clinical experience, preferably in rehabilitation.
• Current RN Licensure in state of operation.
• URAC-recognized Case Management certification required within 3 years of hire if no nationally recognized certification present.
• CCM or CIRS certification preferred.

Responsibilities

• Provide medical case management through coordination with patients, physicians, and 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.
• Make medical recommendations of available treatment plans to payers.
• 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

RN licensure

Clinical experience

Care coordination

Communication skills

Education

Bachelor's degree

Nursing 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 those with clinical expertise who can assess treatment plans and communicate effectively with patients and healthcare providers.

Highlights

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

What You'll Do

• Provide medical case management through coordination with patients, physicians, and 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.
• Make medical recommendations of available treatment plans to payers.
• 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
• Education: 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
• Licenses & Certifications: 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
• Licenses & Certifications: Certification as a CIRS or CCM 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 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. The organization fosters a strong, supportive culture with ample career advancement opportunities.