[Hiring] Medical Case Manager I @CorVel Career Site

Role Description

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in the Pittsburgh, PA area. Work from home, and on the road: Monday – Friday, regular business hours. Traveling outside of home for appointments in a 2-hour radius is required.

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.
• Collaborating with the patient, their family, medical providers, members of our team, and others.
• Managing a caseload of workers compensation injured workers within a defined jurisdiction.

Essential Functions & 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 their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss 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 visit for initial evaluation.
• Implements care such as negotiating the delivery of durable medical equipment and nursing services.
• This role requires regular travel, dependent on the injured worker’s injuries and needs, with availability for local travel up to approximately 60% of the work week/month.
• This role may require overnight travel.
• Additional duties as required.

Qualifications

• Experience as an RN Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred.
• Graduate of accredited school of nursing.
• Current RN Licensure in state of operation.
• Certification as a CCM, CIRS, or other Case Management certifications preferred.
• A valid driver’s license, reliable transportation, and ability to travel to assigned locations is required.

Requirements

• 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.
• 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 Microsoft Office, including Excel spreadsheets.
• Ability to work both independently and within a team environment.

Benefits

• Comprehensive benefits package for full-time regular employees, including:
• 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 and ROTH 401K
• Paid time off
• Medical Case Managers are eligible for bonus.
• State-of-the-art technological devices to ensure ready access to CorVel’s proprietary Case Management application.