- Provides Medical Case Management to individuals through in person and telephonic communications with the patient, physician, other health care providers, employer and others.
- Utilizes their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans.
- Evaluates patient's treatment plan for appropriateness, medical necessity, and cost effectiveness.
- Provides assessment, planning, implementation and evaluation of patient's progress.
- Attends doctors, other providers, home and in some cases, attorney's visits.
- Attends hospital and/or long-term facility discharge planning conferences, et cetera for the purpose of determining appropriateness of care and developing an effective long-term care strategy. Initial home visit for initial evaluation.
- Implements care such as negotiation 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.
- Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment.
- Experience as a RN, Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred.
- Ability to meet with the patient, their physicians, other healthcare providers, attorneys, and advisors/clients and coworkers.
- A cost containment background, such as utilization review or managed care is helpful.
- Strong interpersonal, time management and organizational skills.
- Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets.
- Ability to work both independently and within a team environment.
- Graduate of accredited school of nursing.
- Current RN Licensure in state of operation.
- Certification as a CCM, CIRS, or other Case Management certifications are preferred.
- A valid driver's license, reliable transportation, and ability to travel to assigned locations is required.
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CA Medical Case Manager II - Santa Rosa, United States - CorVel Healthcare Corporation
Description
Job Description
Job DescriptionCorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in the Santa Rosa, CA area.
Work from home, and on the road. Monday – Friday, regular business hours.
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and their families. Your responsibilities include working closely with injured workers to facilitate their recovery. You will work collaboratively with the patient, their family, medical providers, members of our team, and others. This is a heavy local travel role responsible for working with a caseload of workers compensation injured workers within a defined jurisdiction.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
KNOWLEDGE & SKILLS:
EDUCATION & EXPERIENCE:
PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $ $46.47 per hour
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
ABOUT CORVEL:
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 3500 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. In addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel's proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
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