Medical Case Manager

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Pittsburgh, PA. Work from home, and on the road.

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. Candidates must reside in the Pittsburgh, PA area.

ESSENTIAL FUNCTIONS & 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 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.

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.
• Certification as a CCM, CIRS, or other Case Management certifications are preferred.
• This position requires local, distance or otherwise regular travel via vehicle. A valid driver’s license, reliable transportation, and ability to travel to assigned locations is required.

About CorVel
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. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes 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, and paid time off. In addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel’s proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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