Medical Case Manager I

CorVel Corporation is seeking a caring, self-motivated, energetic, and independent registered nurse for a Medical Case Manager role in the Lawrenceville, GA area and surrounding regions. This position offers a hybrid work environment with remote work and local travel required.

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 closely with patients, their families, medical providers, and team members to facilitate recovery. This role involves heavy local travel within a defined jurisdiction to manage a caseload of workers' compensation cases.

Schedule

Monday – Friday, regular business hours. Local travel up to approximately 60% of the work week/month is required, with occasional overnight travel dependent on the injured worker’s needs. Travel radius extends up to a 2-hour radius from the home location.

Responsibilities

• Provide in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other healthcare providers, the employer, and the referral source.
• Utilize medical and nursing knowledge to discuss current and alternate treatment plans with physicians.
• Conduct assessment, planning, implementation, and evaluation of patient progress.
• Evaluate the patient’s treatment plan for appropriateness, medical necessity, and cost-effectiveness.
• Attend doctors' appointments, provider visits, home visits, and attorney meetings as needed.
• Participate in hospital or long-term facility discharge planning conferences to determine care appropriateness and develop long-term care strategies.
• Conduct initial home evaluations.
• Implement care, including negotiating the delivery of durable medical equipment and nursing services.
• Perform additional duties as required.

Requirements

• Must be a registered nurse (RN) with current licensure in the state of operation.
• National certification required (e.g., CCM, COHN, CRRN, CDMS).
• Valid driver’s license, reliable transportation, and ability to travel to assigned locations.
• Experience as an RN Medical Case Manager is ideal; clinical background in orthopedics, neurology, or rehabilitation is preferred.
• Graduate of an accredited school of nursing.

Skills

• Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment.
• Ability to engage with patients, physicians, healthcare providers, attorneys, clients, and coworkers.
• Cost containment background (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 both independently and within a team environment.

Pay

Pay Range: $63,739 - $95,264. CorVel uses a market-based approach to pay, considering factors such as geographic location, job-related skills, experience, qualifications, internal equity, and market conditions. For leveled roles, new hires may be placed at a different level based on experience and qualifications, which may impact the salary range.

Benefits

A comprehensive benefits package is available for full-time regular employees, including:

• 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 FSA accounts.
• 401K and ROTH 401K retirement plans.
• Paid time off.
• Bonus eligibility for Medical Case Managers.
• State-of-the-art technological devices to access CorVel’s proprietary Case Management application.

About CorVel

CorVel is a national provider of industry-leading risk management solutions for workers’ compensation, auto, health, and disability management industries. Founded in 1987 and publicly traded on the NASDAQ, CorVel is a certified Great Place to Work® Company. With over 4,000 employees across the United States, CorVel embraces core values of Accountability, Commitment, Excellence, Integrity, and Teamwork (ACE-IT!).