CA Medical Case Manager I - RN
CorVel - Palmdale, CA
posted 3 months ago
About the position
CorVel Corporation is seeking a dedicated and self-motivated registered nurse to join our team as a Medical Case Manager in San Diego. This position offers the flexibility of working from home while also requiring local travel to meet with injured workers. The role is designed for individuals who are passionate about making a meaningful difference in the lives of injured workers and their families. As a Medical Case Manager, you will be responsible for managing a caseload of workers' compensation injured workers within a defined jurisdiction, ensuring their recovery process is facilitated effectively. In this role, you will engage in both in-person and telephonic communications with patients, physicians, healthcare providers, and employers. Your medical and nursing expertise will be crucial in discussing current treatment plans with physicians and exploring alternative options when necessary. You will evaluate the appropriateness, medical necessity, and cost-effectiveness of treatment plans, providing comprehensive assessment, planning, implementation, and evaluation of each patient's progress. You will also attend various medical appointments, including doctors' visits, hospital discharge planning conferences, and home evaluations, to determine the appropriateness of care and develop effective long-term care strategies. This position requires regular travel, with approximately 60% of your work week dedicated to local travel, and may also involve overnight trips depending on the needs of the injured workers you are assisting.
Responsibilities
- Provides Medical Case Management to individuals through in person and telephonic communications with the patient, physician, other health care providers, employer and others.
- Utilizes 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 for the purpose of determining appropriateness of care and developing an effective long-term care strategy.
- Implements care such as negotiation the delivery of durable medical equipment and nursing services.
Requirements
- Graduate of accredited school of nursing.
- Current RN Licensure in state of operation.
- Experience as a RN, Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred.
- A valid driver's license, reliable transportation, and ability to travel to assigned locations is required.
- Strong interpersonal, time management and organizational skills.
- Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets.
Nice-to-haves
- Certification as a CCM, CIRS, or other Case Management certifications are preferred.
- A cost containment background, such as utilization review or managed care is helpful.
Benefits
- 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
- Paid time off
- Bonus eligibility for Medical Case Managers
- State-of-the-art technological devices for case management application access
