CA Medical Case Mgr III

CorVel Career Site•Folsom, CA

9d•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 California. This is a work-from-home role that also requires local travel. The Medical Case Manager will make a meaningful difference in the lives of injured workers and their families by working closely with them to facilitate their recovery. This role involves collaboration with the patient, their family, medical providers, and other team members. It is a heavy local travel role responsible for managing a caseload of workers' compensation injured workers within a defined jurisdiction.

Requirements

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.
Graduate of accredited school of nursing.

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 explore 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 visits for initial evaluation.
Implements care such as negotiating the delivery of durable medical equipment and nursing services.
Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”).
Additional duties as required.