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Telephonic Case Manager II

2 months ago

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

CorVel Corporation is seeking a highly skilled Telephonic Case Manager II to join our team. As a Telephonic Case Manager II, you will be responsible for 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 health care providers, the employer, and the referral source.
  • Assess, plan, implement, and evaluate 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.
  • Negotiate and coordinate 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 telephone extensively and maintain regular and consistent attendance.
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 Corporation 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. In addition, 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.

About CorVel Corporation

CorVel Corporation is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT).