Medical Case Manager
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Upload Your ResumeAbout This Role
This role involves providing in-person and telephonic Medical Case Management to injured workers, facilitating their recovery by collaborating with medical providers, and evaluating treatment plans for appropriateness and cost-effectiveness. The Medical Case Manager will make a significant impact by guiding patients through their recovery process and ensuring effective long-term care strategies.
Responsibilities
- Provide in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer, and the referral source
- Utilize medical and nursing knowledge to discuss current and alternate treatment plans with physicians
- Provide assessment, planning, implementation, and evaluation of patient’s progress
- Evaluate patient’s treatment plan for appropriateness, medical necessity, and cost effectiveness
- Attend doctors, other providers, home, and, in some cases, attorney’s visits
- Attend hospital and/or long-term facility discharge planning conferences for determining appropriateness of care and developing effective long-term care strategies
- Conduct home visits for initial evaluations
- Implement care such as negotiating the delivery of durable medical equipment and nursing services
- Regularly travel locally up to approximately 60% of the work week/month
- Comply with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program
Requirements
- Current RN Licensure in state of operation
- Graduate of accredited school of nursing
- Ability to travel to assigned locations
- Valid driver’s license
- Reliable transportation
Qualifications
- Graduate of accredited school of nursing
- Experience as an RN Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred
Nice to Have
- Experience as an RN Medical Case Manager
- Clinical background in orthopedics, neurology, or rehabilitation
- Certification as a CCM, CIRS, or other Case Management certifications
- Cost containment background (e.g., utilization review or managed care)
Skills
* Required skills
Benefits
Certifications
About CorVel Corporation
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.