CorVel
Telephonic Case Manager I
The Telephonic Case Manager supports a dedicated customer by coordinating resources and creating flexible, cost-effective options for injured individuals on a case-by-case basis. The goal is to facilitate high-quality individualized treatment plans that support timely return-to-work when appropriate. Leveraging their clinical expertise, the Telephonic Case Manager evaluates the patient's current treatment plan for medical appropriateness based on their physical and medical status. This role includes collaborating with treating physicians to review the patient's condition, and when appropriate, discussing or recommending alternative treatment options
all while aligning with the dedicated customer's specific program goals, processes and expectations. The Telephonic Case Manager must also have the ability to clearly explain medical conditions and treatment plans to the patient, family members and adjuster, supporting the goals of the account, the Case Management department and CorVel. Essential Functions And Responsibilities: Provides medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source Provide assessment, planning, implementation, and evaluation of patient's progress Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness Ability to utilize their medical and nursing knowledge to allow the case manager to discuss the current treatment plan with the physician and discuss alternate treatment plans Ability to make medical recommendations of available treatment plans to the payer Implement care such as negotiating and coordinating the delivery of durable medical equipment and nursing services Ability to make independent medical decisions and recommendations to all parties Devise cost-effective strategies for medical care Required to read extensively Required to prepare organized reports within a specified timeframe Required to use telephone extensively Minimum Productivity Standard is 95% per month Requires regular and consistent attendance Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP) Additional duties as required Knowledge & Skills: Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment Ability to interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers Excellent written and verbal communication skills Ability to meet designated deadlines Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets Strong interpersonal, time management and organizational skills Ability to work both independently and within a team environment Education/Experience: 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 Pay Range: CorVel uses a market-based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $62,306
$93,123 A list of our benefit offerings can be found on our CorVel website. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
The Telephonic Case Manager supports a dedicated customer by coordinating resources and creating flexible, cost-effective options for injured individuals on a case-by-case basis. The goal is to facilitate high-quality individualized treatment plans that support timely return-to-work when appropriate. Leveraging their clinical expertise, the Telephonic Case Manager evaluates the patient's current treatment plan for medical appropriateness based on their physical and medical status. This role includes collaborating with treating physicians to review the patient's condition, and when appropriate, discussing or recommending alternative treatment options
all while aligning with the dedicated customer's specific program goals, processes and expectations. The Telephonic Case Manager must also have the ability to clearly explain medical conditions and treatment plans to the patient, family members and adjuster, supporting the goals of the account, the Case Management department and CorVel. Essential Functions And Responsibilities: Provides medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source Provide assessment, planning, implementation, and evaluation of patient's progress Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness Ability to utilize their medical and nursing knowledge to allow the case manager to discuss the current treatment plan with the physician and discuss alternate treatment plans Ability to make medical recommendations of available treatment plans to the payer Implement care such as negotiating and coordinating the delivery of durable medical equipment and nursing services Ability to make independent medical decisions and recommendations to all parties Devise cost-effective strategies for medical care Required to read extensively Required to prepare organized reports within a specified timeframe Required to use telephone extensively Minimum Productivity Standard is 95% per month Requires regular and consistent attendance Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP) Additional duties as required Knowledge & Skills: Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment Ability to interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers Excellent written and verbal communication skills Ability to meet designated deadlines Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets Strong interpersonal, time management and organizational skills Ability to work both independently and within a team environment Education/Experience: 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 Pay Range: CorVel uses a market-based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $62,306
$93,123 A list of our benefit offerings can be found on our CorVel website. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.