Telephonic Case Manager I - RN

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 Telephonic Case Manager - RN coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, when appropriate, a timely return to work. This role uses clinical expertise to assess the appropriateness of current treatment plans based on the patient’s medical and physical condition. The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options when needed. They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel. This is a remote position

Provide 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 Utilize medical and nursing knowledge to discuss the current treatment plan/alternate treatment plans with the physician 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 Devise cost-effective strategies for medical care Required to prepare organized reports within a specified timeframe Minimum Productivity Standard is 95% per month Additional duties as assigned