CA Utilization Review Case Manager I
About the role
The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel. This is a remote position. 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. Founded in 1987 and publicly traded on NASDAQ since 1991, CorVel employs over 4,000 people across the United States and embraces core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE‑IT!).
Responsibilities
- Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer
- Collects data and analyzes information to make decisions regarding certification or denial of treatment
- Documents all work in the appropriate manner
- Promotes utilization review services with stakeholders
- Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
- Additional duties as assigned