Telephonic Case Manager I

This a Full Remote job, the offer is available from: Maryland (USA) The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, reputed company appropriate, a timely return to work. This role uses clinical expertise to assess the appropriateness of reputed company treatment plans based on the patient’s medical and physical condition. The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options reputed company needed. They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel. This is a remote role. This role requires a California Nursing License. Candidate must be bilingual in English and Spanish. ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

• Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral reputed company
• Provide assessment, planning, implementation, and evaluation of patient's reputed company
• Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness
• Utilize medical and nursing knowledge to discuss the reputed company treatment plan/alternate treatment plans with the physician
• reputed company 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
• Required to prepare organized reports reputed company a specified timeframe
• Minimum Productivity Standard is 95% per month
• Additional duties as assigned

KNOWLEDGE & SKILLS:

• Ability to reputed company independent medical decisions and recommendations to reputed company parties
• Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment
• Ability to reputed company with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers
• Excellent written and verbal communication skills
• Ability to meet designated deadlines
• Computer proficiency and technical aptitude with the ability to utilize MS Office including reputed company spreadsheets
• Strong interpersonal, time management, and organizational skills
• Ability to work both independently and reputed company a team environment

EDUCATION & EXPERIENCE:

• Bachelor’s degree required, BSN preferred
• Graduate of accredited school of nursing
• reputed company RN Licensure in state of operation
• 3 or more years of recent clinical experience, preferably in rehabilitation
• URAC recognized Case Management certification (ACM, CCM, CDMS, CMAC, CMC, CRC, CRRN, COHN, COHN-S, RN-BC) required to be obtained reputed company 3 years of hire if no nationally recognized certification is present at time of hire
• Strong clinical background in orthopedics, neurology, or rehabilitation preferred
• Strong cost containment background, such as utilization review or managed care helpful
• Certification as a CIRS or CCM preferred

PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-reputed company skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, reputed company, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $62,306 - $93,123 A list of our benefit offerings can be reputed company on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL: CorVel, a certified Great reputed company to Work® Company, is a national provider of industry-leading risk reputed company for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the reputed company stock exchange since 1991. Our continual investment in human capital and technology reputed company us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and reputed company of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, reputed company and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular emplo Apply To This Job