CA Medical Case Manager I

CorVel Corporation•Folsom, CA

6d•$31 - $46•Remote

About The Position

CorVel Corporation is hiring a registered nurse to provide medical case management for workers’ compensation patients in California. The role works from home and in the field, managing a caseload of injured workers within an assigned jurisdiction and facilitating their recovery in collaboration with patients, families, physicians, other healthcare providers, employers, referral sources, and CorVel team members. It is a remote position with heavy local travel, generally Monday through Friday during regular business hours. Travel may reach approximately 60% of the work week or month, depending on patients’ needs, and overnight travel may be required. The Medical Case Manager provides in-person and telephonic case management, assesses and evaluates patient progress and treatment plans, and works with physicians to discuss current and alternate treatment plans. The role evaluates treatment for appropriateness, medical necessity, and cost effectiveness; attends provider, home, and sometimes attorney visits; participates in hospital or long-term facility discharge planning; conducts initial home evaluations; and coordinates care such as durable medical equipment and nursing services. The employee must comply with applicable safety rules and the Injury and Illness Prevention Program. CorVel describes itself as a national provider of risk management solutions for workers’ compensation, auto, health, and disability management. It was founded in 1987, has been publicly traded on NASDAQ since 1991, and has more than 4,000 employees across the United States. Full-time regular employees are eligible for 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, reliable transportation, and ability to travel to assigned locations.
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 or clients, and coworkers.
Strong interpersonal, time-management, and organizational skills.
Computer proficiency and technical aptitude, including the ability to use Microsoft Office and Excel spreadsheets.
Ability to work 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.
Cost containment background, such as utilization review or managed care, is helpful.
CCM, CIRS, or other case management certification is preferred.

Responsibilities

Provide in-person and telephonic medical case management involving patients, physicians, other healthcare providers, employers, and referral sources.
Use medical and nursing knowledge to discuss current treatment plans with physicians and consider alternate plans.
Assess, plan, implement, and evaluate patient progress.
Evaluate treatment plans for appropriateness, medical necessity, and cost effectiveness.
Attend visits with doctors, other providers, patients at home, and, in some cases, attorneys.
Attend hospital and long-term facility discharge planning conferences to assess appropriate care and develop long-term care strategies.
Conduct initial evaluation home visits.
Coordinate care, including durable medical equipment and nursing services.
Travel locally to assigned locations as required, potentially up to approximately 60% of the work week or month, with possible overnight travel.
Follow safety rules and regulations and comply with the Injury and Illness Prevention Program.
Perform additional duties as required.