Medical Case Manager I

at  CorVel Corporation

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Myrtle Beach, SC.
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.

KNOWLEDGE & SKILLS:

• 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.

EDUCATION & EXPERIENCE:

• Graduate of accredited school of nursing.
• Current RN Licensure in state of operation (MI required, OH preferred). May need to obtain OH license in future if not already obtained.
• 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.

• 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.