CA Medical Case Manager I

CorVel Corporation•Folsom, CA

7h•Hybrid

About The Position

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Fresno, CA. This is a work-from-home and on-the-road position, with regular business hours, Monday – Friday. As a Medical Case Manager, you will make a meaningful difference in the lives of injured workers and their families by working closely with them to facilitate their recovery. You will collaborate with the patient, their family, medical providers, and other team members. This is a heavy local travel role responsible for managing a caseload of workers' compensation injured workers within a defined jurisdiction.

Requirements

Graduate of accredited school of nursing
Current RN Licensure in state of operation
A valid driver’s license, reliable transportation, and ability to travel to assigned locations is required
Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment
Ability to meet with the patient, their physicians, other healthcare providers, attorneys, advisors/clients, and coworkers
Strong interpersonal, time management, and organizational skills
Computer proficiency and technical aptitude with the ability to utilize Microsoft Office, including Excel spreadsheets
Ability to work both independently and within a team environment

Nice To Haves

Experience as an RN Medical Case Manager is ideal
Clinical background in orthopedics, neurology, or rehabilitation is preferred
Certification as a CCM, CIRS, or other Case Management certifications preferred
A cost containment background, such as utilization review or managed care is helpful

Responsibilities

Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer, and the referral source.
Utilizes medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans.
Provides assessment, planning, implementation, and evaluation of patient’s progress.
Evaluates patient’s treatment plan for appropriateness, medical necessity, and cost effectiveness.
Attends doctors, other providers, home and in some cases, attorney’s visits.
Attends hospital and/or long-term facility discharge planning conferences for the purpose of determining appropriateness of care and developing an effective long-term care strategy.
Conducts home visit for initial evaluation.
Implements care such as negotiating the delivery of durable medical equipment and nursing services.
This role requires regular travel, dependent on the injured worker’s injuries and needs. The employee must be available for local travel up to approximately 60% of the work week/month.
This role may require overnight travel.
Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”).
Additional duties as required.