Quality Assurance Nurse

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 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!).

The Quality Assurance Nurse is responsible for case management quality assurance and mentorship of operations staff, providing tools and calibrating processes, while ensuring consistent delivery of CorVel’s case management services. This is a remote position.

Develop, implement, and provide ongoing quality assurance calibration of processes as well as a case management mentoring, both managed and delivered at the operational level Educate and equip operations with performance measurement and reporting tools that can be used to objectively measure and grow operations Provide national account and regulatory quality oversight As applicable, provide oversight and management of URAC compliance and renewals Work with executive, general and case management department management to ensure the case management department successfully implemented and is adhering to CorVel standards (including quality assurance, reporting, and management processes) Work closely with new hires to ensure consistent and full integration/training of all case management managers to CorVel standards as well as training for system usage pertaining to case management and reporting Identify developmental needs and and participate in training of case management leadership, including the training/re-training of all offices on standards and procedures, and usages of the CorVel case management and reporting system Develop, run and interpret management reports to ensure the case management operations are utilizing the tools available to manage compliance of services delivery within company standards Facilitate peer-to-peer quality reviews to ensure delivery of quality case management Review results and outcomes with general management and case management leadership and develop action plans where warranted Make recommendations in collaboration with field operations to ensure actions toward improvement are identified Develop and oversee case management manager mentor program to facilitate the onboarding of new supervision and management to equip field with the tools for compliance and consistency of CorVel standards and procedures Implementation, oversight and communication of regulatory requirements within case management services to include, state, federal and URAC Identify trends and recommend action plans to management for continuous process improvement Ability to travel up to fifty percent of the time Additional duties as assigned