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Healthcare Case Management Coordinator

2 months ago

Downers Grove, Illinois, United States CorVel Healthcare Corporation Full time
Job Summary

CorVel Healthcare Corporation is seeking a highly skilled and experienced Telephonic Case Manager II to join our team. As a Telephonic Case Manager II, 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
  • Provide medical case management to individuals through coordination with the patient, the physician, other healthcare providers, the employer, and the referral source.
  • Assess, plan, implement, and evaluate patient progress.
  • Evaluate patient treatment plans for appropriateness, medical necessity, and cost-effectiveness.
  • Utilize medical and nursing knowledge to discuss current treatment plans with physicians and recommend alternate treatment plans.
  • Make medical recommendations to payers and 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.
  • Develop cost-effective strategies for medical care.
  • Read extensively and prepare organized reports within a specified timeframe.
  • Use the 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 an accredited school of nursing.
  • Current RN licensure in the state of operation.
  • Three 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 three 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 Healthcare Corporation offers a comprehensive benefits package, including medical, 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, 401(k), ROTH 401(k), and paid time off. Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel's proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur.

CorVel Healthcare Corporation is an Equal Opportunity Employer, drug-free workplace, and complies with ADA regulations as applicable.