Case Management Coordinator II

2 weeks ago

Downers Grove, Illinois, United States CorVel Corporation Full time

The Telephonic Case Management Specialist is responsible for orchestrating resources and devising adaptable, cost-efficient solutions for individuals facing health challenges on a personalized basis to promote quality treatment objectives, including timely return-to-work strategies when suitable. This role necessitates leveraging medical expertise to assess the patient's ongoing treatment regimen for clinical relevance based on their health status.

KEY FUNCTIONS AND RESPONSIBILITIES:

Administers medical case management for individuals through collaboration with the patient, healthcare providers, employers, and referral sources. Conducts assessments, planning, implementation, and evaluation of the patient's progress. Reviews the patient's treatment plan for clinical appropriateness, medical necessity, and cost efficiency. Utilizes medical and nursing knowledge to engage in discussions regarding the current treatment plan with physicians and propose alternative treatment options. Makes informed medical recommendations regarding available treatment plans to payers. Coordinates care by negotiating and arranging the provision of durable medical equipment and nursing services. Exercises independent medical judgment and recommendations to all involved parties. Develops cost-effective strategies for healthcare delivery. Engages in extensive reading as part of ongoing professional development. Prepares organized reports within designated timeframes. Utilizes telephone communication extensively. Achieves a minimum productivity standard of 95% monthly. Maintains regular and consistent attendance. Adheres to all safety protocols and regulations during work hours in alignment with the Injury and Illness Prevention Program (IIPP). Performs additional duties as required.

REQUIRED KNOWLEDGE & SKILLS:

Proficient multi-tasking abilities in a high-volume, fast-paced, team-oriented environment. Capable of interfacing with claims personnel, attorneys, physicians, and their representatives, as well as clients and colleagues. Exceptional written and verbal communication skills. Ability to meet established deadlines. Proficient in computer usage and technical skills, particularly with MS Office, including Excel. Strong interpersonal, time management, and organizational capabilities. Ability to work independently as well as collaboratively within a team setting.

EDUCATION AND EXPERIENCE:

Bachelor's degree required; BSN preferred. Graduate of an accredited nursing program. Current RN Licensure in the state of operation. Minimum of 3 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) must be obtained within 3 years of hire if no nationally recognized certification is present at the time of hire. Strong clinical background in orthopedics, neurology, or rehabilitation is preferred. Background in cost containment, such as utilization review or managed care, is advantageous. Certification as a CIRS or CCM is preferred.

COMPENSATION:

CorVel employs a market-based approach to compensation, and salary ranges may vary based on location. Pay rates are determined by factors such as federal, state, and local minimum wage requirements, geographic location differentials, job-related skills, experience, qualifications, internal employee equity, and market conditions. Salary ranges may be adjusted at any time.

For leveled positions (I, II, III, Senior, Lead, etc.), new hires may be placed at a different level, either higher or lower, based on evaluations during the interview process, considering experience, qualifications, and overall suitability for the role. This level may influence the salary range, and adjustments will be clarified during the offer process.

Pay Range: $63,902 – $96,662

A comprehensive benefits package is available for full-time regular employees, including Medical (HDHP) with 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. Additionally, Medical Case Managers are eligible for bonuses and will receive state-of-the-art technological devices to ensure immediate access to CorVel's proprietary Case Management application, allowing staff to retrieve documents on the go and log activities as they occur.

About CorVel – Medical Case Managers 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 sectors. Established in 1987 and publicly traded on the NASDAQ since 1991, our ongoing investment in human capital and technology enables us to deliver innovative and integrated solutions to our clients. We are a stable and growing organization with a strong, supportive culture and ample opportunities for career advancement. Over 4,000 individuals across the United States uphold our core values of Accountability, Commitment, Excellence, Integrity, and Teamwork (ACE-IT).

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

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