Telephonic Case Manager II

1 day ago


Rancho Cucamonga, California, United States CorVel Healthcare Corporation Full time
Job Summary

We are seeking a skilled Telephonic Case Manager II to join our team at CorVel Healthcare Corporation. 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.
  • Discuss current treatment plans with physicians and recommend alternate treatment plans.
  • Make medical recommendations to payers.
  • 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.
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.
What We Offer

CorVel 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.

We are an Equal Opportunity Employer, drug-free workplace, and comply with ADA regulations as applicable.



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