Telephonic Case Manager

4 weeks ago


Livermore, California, United States CorVel Corporation Full time
Job Summary

The Telephonic Case Manager coordinates resources and creates flexible, cost-effective options for individuals with medical needs to facilitate quality individualized treatment goals. This role requires strong clinical knowledge to evaluate treatment plans for medical appropriateness and discuss medical conditions with physicians and patients.

Key Responsibilities
  • Provides medical case management to individuals through coordination with patients, physicians, and healthcare providers.
  • Assesses, plans, implements, and evaluates patient progress to ensure effective treatment outcomes.
  • Evaluates treatment plans for medical necessity, cost-effectiveness, and appropriateness.
  • Discusses medical conditions and treatment plans with patients, family members, and adjusters to support treatment goals.
  • Coordinates care, including negotiating and delivering durable medical equipment and nursing services.
  • Makes independent medical decisions and recommendations to all parties involved.
  • Develops cost-effective strategies for medical care and ensures compliance with safety regulations.
Requirements
  • Bachelor's degree in nursing or related field.
  • Current RN licensure in the state of operation.
  • 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) required within 3 years of hire.
  • Strong clinical background in orthopedics, neurology, or rehabilitation preferred.
About CorVel

CorVel is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health, and disability management industries. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.



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