Medical Case Manager I

CorVel Career Site•Georgetown, KY

9d•Remote

About The Position

CorVel Corporation is hiring a registered nurse to provide medical case management for workers’ compensation claimants in Kentucky, preferably in the Georgetown/Lexington area. The role is work-from-home and on the road, with Monday–Friday regular business hours. It involves working closely with injured workers and their families to facilitate recovery, collaborating with patients, family members, medical providers, CorVel team members, employers, referral sources, and others. This is a heavy local-travel role managing a caseload within a defined jurisdiction, with travel of up to approximately 60% of the work week/month and possible overnight travel. The Medical Case Manager provides in-person and telephone-based case management, applies nursing knowledge to review treatment plans with physicians and discuss alternatives, and assesses and evaluates patient progress. The role also involves reviewing treatment for appropriateness, medical necessity, and cost effectiveness; attending medical, home, and sometimes attorney visits; participating in hospital and long-term facility discharge planning; conducting initial home evaluations; and arranging care such as durable medical equipment and nursing services. CorVel describes itself as a national provider of risk management solutions for workers’ compensation, auto, health, and disability management. Founded in 1987 and publicly traded since 1991, the company has more than 4,000 employees across the United States. Full-time regular employees are offered a comprehensive benefits package. Medical Case Managers are also eligible for a bonus and receive technological devices for access to CorVel’s Case Management application.

Requirements

Graduate of an accredited school of nursing.
Current RN licensure in the state of operation.
Valid driver’s license and reliable transportation.
Ability to travel to assigned locations, including local travel up to approximately 60% of the work week/month; overnight travel may be required.
Effective communication and multitasking skills in a high-volume, fast-paced, team-oriented environment.
Ability to meet with patients, physicians, other healthcare providers, attorneys, advisors/clients, and coworkers.
Strong interpersonal, time management, and organizational skills.
Computer proficiency and technical aptitude, including ability to use Microsoft Office and Excel spreadsheets.
Ability to work independently and within a team environment.

Nice To Haves

National certification such as CCM, COHN, or CRRN.
Experience as an RN Medical Case Manager or a clinical background in orthopedics, neurology, or rehabilitation.
Cost containment background, such as utilization review or managed care.
Certification as a CCM, CIRS, or other case management certification.

Responsibilities

Provide in-person and telephonic medical case management involving the patient, physician, other healthcare providers, employer, and referral source.
Use medical and nursing knowledge to discuss the current treatment plan with physicians and consider alternate treatment plans.
Assess, plan, implement, and evaluate patient progress.
Evaluate treatment plans for appropriateness, medical necessity, and cost effectiveness.
Attend visits with doctors and other providers, home visits, and, in some cases, attorney visits.
Attend hospital and long-term facility discharge planning conferences to determine appropriateness of care and develop a long-term care strategy.
Conduct home visits for initial evaluations.
Implement care arrangements, including coordinating delivery of durable medical equipment and nursing services.
Manage a workers’ compensation caseload within a defined jurisdiction and travel locally to meet injured workers’ needs.
Perform additional duties as required.