Telephonic Case Manager - Part Time
Posted on Aug 11, 2019 by CorVel Corporation
CorVel is seeking a part time 30 hour a week Telephonic Case Manager for our Colorado office. Applicants must reside in CO (preferably Denver metro area). The Telephonic Case Manager coordinates resources and creates flexible, cost-effective options for ill or injured individuals on a case-by-case basis to facilitate quality individualized treatment goals, including timely return-to-work if appropriate. The Telephonic Case Manager will rely on their medical knowledge to evaluate the patient's current treatment plan for medical appropriateness based on their physical and medical status. The Telephonic Case Manager must be able to discuss the patient's medical and physical conditions with the treating physicians, along with discussing/recommending alternate treatment plans for the patient.
This position is benefit eligible
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Provides medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source.
- Assist in completing First Report of Injury/Illness form, investigate claim, as appropriate, and processes completed First Report forms per state regulations and customer guidelines.
- Coordinate Independent Medical Evaluations.
- Provide assessment, planning, implementation, and evaluation of patient's progress.
- Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness.
- Ability to utilize their medical and nursing knowledge to allow the case manager to discuss the current treatment plan with the physician and discuss alternate treatment plans.
- Ability to make medical recommendations of available treatment plans to the payer.
- Implement care such as negotiating and coordinating the delivery of durable medical equipment and nursing services.
- Ability to make independent medical decisions and recommendations to all parties.
- Devise cost-effective strategies for medical care.
- Required to read extensively.
- Required to prepare organized reports within a specified timeframe.
- Required to use telephone extensively.
- Minimum Productivity Standard is 95%
- Requires regular and consistent attendance.
- Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP).
- Additional duties as required.
KNOWLEDGE & SKILLS:
- Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment.
- Ability to interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers.
- Excellent written and verbal communication skills.
- Ability to meet designated deadlines
- Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets
- Strong interpersonal, time management and organizational skills.
- Ability to work both independently and within a team environment.
- Graduate of accredited school of nursing
- Current RN Licensure in state of operation
- 3 or more years of recent clinical experience, preferably in rehabilitation.
- URAC recognized Case Management certification (ACM, CCM, CDMS, CMAC, CMC, CRC, CRRN, COHN, COHN-S, RN-BC) required to be obtained within 3 years of hire if no nationally recognized certification is present at time of hire.
- Strong clinical background in orthopedics, neurology, or rehabilitation preferred.
- Strong cost containment background, such as utilization review or managed care helpful.
- Certification as a CIRS or CCM preferred.
We are an Equal Opportunity Employer. All persons shall have the opportunity to be considered for employment without regard to their race, color, age, sex, gender, religion, national origin, ancestry, citizenship status, physical or mental disability, military service, veteran status or any other characteristic protected by applicable federal, state or local law.
We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this application or to participate in an interview, please let us know.
Note to Employment Agencies: Please do not forward agency resumes. CorVel Corporation is not responsible for any fees related to unsolicited resumes.
Please be aware that CorVel generally does not review all applications/resumes submitted in response to job openings posted on the Internet because of the large volume of responses