Telephonic Case Manager I

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

Benefits offered by this job

Medical (HDHP) w/Pharmacy

Dental and 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, a national provider of risk management solutions, is seeking 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.

You will assess, plan, implement, and evaluate patient progress, discuss treatment options with physicians, and negotiate services to ensure cost-effectiveness while preparing organized reports.

Qualifications

• Bachelor's degree required; BSN preferred
• Graduate of accredited school of nursing
• Current RN licensure in state of operation
• URAC-recognized Case Management certification required within 3 years of hire if no nationally recognized certification is present at time of hire
• Certification as a CIRS or CCM preferred

Responsibilities

• Provide medical case management to individuals through coordination with the patient, physician, and other healthcare 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 current and alternate treatment plans with the physician.
• Make medical recommendations of available treatment plans to the payer.
• Implement care by 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.

Education

Bachelor's 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 facilitate timely returns to work.

Highlights

• Pay: $63,739 - $95,264/year
• Location: Remote, TN
• 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 healthcare 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 current and alternate treatment plans with the physician.
• Make medical recommendations of available treatment plans to the payer.
• Implement care by 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
• 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 promotes a strong, supportive culture with ample career advancement opportunities.