Telephonic Case Manager RN
1 day ago
CorVel Healthcare Corporation is seeking a skilled Telephonic Case Manager RN to join our team. As a Telephonic Case Manager RN, you will play a critical role in coordinating resources and creating flexible, cost-effective options for ill or injured individuals on a case-by-case basis to facilitate quality individualized treatment goals, including timely return-to-work if appropriate.
Key Responsibilities:
- Coordinate medical case management to individuals through coordination with the patient, the physician, other healthcare providers, the employer, and the referral source.
- 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 treatment plan with physician and discuss alternate treatment plans.
- 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.
- Make independent medical decisions and recommendations to all parties.
- Devise cost-effective strategies for medical care.
- Read extensively and prepare organized reports within a specified timeframe.
- Use telephone extensively and maintain regular and consistent attendance.
- Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP).
Requirements:
- Bachelor's degree required, BSN desirable.
- Graduate of accredited school of nursing.
- Current 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 within 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.
Benefits:
CorVel offers a comprehensive benefits package, including 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, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug-free workplace, and complies with ADA regulations as applicable.
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