CA Medical Case Manager II

CorVel Corporation is seeking a caring, self-motivated, energetic, and independent registered nurse for a Medical Case Manager role in San Diego, CA. This position offers a hybrid work environment with work-from-home flexibility and local travel.

About the Role

As a Medical Case Manager, you will make a meaningful difference in the lives of injured workers and their families. You will collaborate with patients, their families, medical providers, and other team members to facilitate recovery within the workers' compensation system. This role involves significant local travel (up to 60% of the workweek) and may occasionally require overnight travel.

Responsibilities

• Provide in-person and telephonic medical case management to individuals, involving patients, physicians, healthcare providers, employers, and referral sources.
• Utilize medical and nursing knowledge to discuss current treatment plans with physicians and explore alternative options.
• Perform assessment, planning, implementation, and evaluation of patient progress.
• Evaluate treatment plans for appropriateness, medical necessity, and cost-effectiveness.
• Attend doctor appointments, provider visits, home visits, and attorney meetings as needed.
• Participate in hospital or long-term facility discharge planning to develop effective long-term care strategies.
• Conduct initial home evaluations and implement care, such as negotiating durable medical equipment and nursing services.
• Comply with all safety rules and regulations, including the Injury and Illness Prevention Program (IIPP).
• Perform additional duties as required.

Requirements

• Current RN licensure in the state of operation (California).
• Valid driver’s license, reliable transportation, and ability to travel to assigned locations (up to 60% local travel).
• Graduate of an accredited school of nursing.
• Experience as an RN Medical Case Manager is ideal; clinical background in orthopedics, neurology, or rehabilitation is preferred.
• Certification as a CCM, CIRS, or other case management certifications is a plus.

Skills

• Effective communication and multitasking in a high-volume, fast-paced, team-oriented environment.
• Ability to engage with patients, physicians, healthcare providers, attorneys, clients, and coworkers.
• Cost containment experience (e.g., utilization review or managed care) is helpful.
• Strong interpersonal, time management, and organizational skills.
• Computer proficiency with Microsoft Office, including Excel spreadsheets.
• Ability to work independently and collaboratively within a team.

Pay

Pay Range: $32.18 - $48.68 per hour. CorVel uses a market-based approach to compensation, considering factors such as location, skills, experience, qualifications, internal equity, and market conditions. For leveled roles, new hires may be placed at a different level based on assessment during the interview process.

Benefits

• Medical (HDHP) with Pharmacy coverage.
• Dental and Vision insurance.
• Long-Term Disability and Life Insurance.
• Accident, Critical Illness, and Pre-paid Legal Insurance.
• Health Savings Account (HSA) and Flexible Spending Account (FSA) options, including Parking and Transit FSAs.
• 401K and ROTH 401K retirement plans.
• Paid time off.
• Bonus eligibility for Medical Case Managers.
• State-of-the-art technological devices for remote access to CorVel’s proprietary Case Management application.

Schedule

Monday – Friday, regular business hours.

About CorVel

CorVel is a national provider of industry-leading risk management solutions for workers’ compensation, auto, health, and disability management. Founded in 1987 and publicly traded on NASDAQ, CorVel invests in human capital and technology to deliver innovative solutions. The company fosters a supportive culture with over 4,000 employees across the U.S., embracing core values of Accountability, Commitment, Excellence, Integrity, and Teamwork (ACE-IT!). CorVel is a certified Great Place to Work® and an Equal Opportunity Employer.