Telephonic Case Manager III

2 weeks ago

Downers Grove, Illinois, United States CorVel Corporation Full time

The Telephonic Case Manager plays a crucial role in orchestrating resources and developing adaptable, cost-efficient solutions for individuals facing health challenges. This position focuses on delivering personalized treatment objectives, including facilitating a timely return to work when feasible. Utilizing their medical expertise, the Telephonic Case Manager assesses the appropriateness of the patient's current treatment plan based on their health status.

KEY RESPONSIBILITIES:

Coordinate medical case management by collaborating with patients, healthcare providers, employers, and referral sources. Conduct thorough assessments, planning, implementation, and evaluation of patient progress. Review treatment plans for medical necessity, appropriateness, and cost-effectiveness. Leverage medical and nursing knowledge to engage in discussions with physicians regarding treatment plans and alternatives. Provide medical recommendations for available treatment options to payers. Facilitate care by negotiating and coordinating the provision of medical equipment and nursing services. Make independent medical decisions and recommendations to all stakeholders. Develop cost-effective strategies for delivering medical care. Maintain organized reports and documentation within set deadlines. Utilize telecommunication extensively to manage cases effectively. Adhere to a minimum productivity standard of 95% monthly. Ensure regular attendance and compliance with safety regulations during work hours. Perform additional duties as required.

REQUIRED SKILLS AND KNOWLEDGE:

Strong multi-tasking abilities in a fast-paced, team-oriented environment. Proficient in interacting with claims staff, attorneys, physicians, and clients. Excellent verbal and written communication skills. Ability to meet strict deadlines. Proficient in MS Office applications, including Excel. Strong organizational, time management, and interpersonal skills. Capable of working independently as well as collaboratively within a team.

EDUCATION AND EXPERIENCE:

Bachelor's degree required; BSN preferred. Graduate of an accredited nursing program. Current RN licensure in the relevant state. Minimum of three years of recent clinical experience, preferably in rehabilitation. URAC recognized Case Management certification (e.g., ACM, CCM) must be obtained within three years of hire if not already certified. Preferred background in orthopedics, neurology, or rehabilitation. Experience in cost containment, such as utilization review or managed care, is beneficial. Certification as a CIRS or CCM is preferred.

COMPENSATION:

CorVel employs a market-based approach to compensation, with salary ranges varying by location and influenced by factors such as minimum wage laws, geographic differentials, job-related skills, experience, and market conditions. Pay ranges may be adjusted as necessary.

For roles with different levels (I, II, III, Senior, Lead, etc.), new hires may be assigned to a different level based on an assessment during the interview process, which considers experience and qualifications. This level may affect the salary range, and any adjustments will be clarified during the offer process.

Pay Range: $63,902 – $96,662

A comprehensive benefits package is available for full-time employees, including medical, dental, vision, long-term disability, health savings accounts, flexible spending accounts, life insurance, and retirement plans. Medical Case Managers are also eligible for bonuses and provided with advanced technological tools to access CorVel's proprietary Case Management application.

About CorVel Corporation: CorVel is a national leader in risk management solutions across various industries, including workers' compensation and health management. Established in 1987 and publicly traded since 1991, CorVel is committed to innovation and excellence, fostering a supportive culture and offering ample career advancement opportunities.

CorVel is an Equal Opportunity Employer and maintains a drug-free workplace.

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