6 medical case manager ii jobs found

The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, when appropriate, a timely return to work. This role uses clinical expertise to assess the appropriateness of current treatment plans based on the patient’s medical and physical condition. The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options when needed. They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source Provide assessment, planning, implementation, and evaluation of...

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in the Northern VA area (Fairfax, Alexandira, etc). 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. Candidates must reside in the Northern VA area. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the...

The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and jurisdictional guidance to claims staff...

The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and jurisdictional guidance to claims staff...

The 24/7 Shift Supervisor is responsible for directing clinical operation of designated Advocacy 24/7 shift, which may include one or more of the following functions: human resources, customer service, and information technology. This role requires internet upload and download speeds of at least 80Mbps. This is a remote role.  ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Responsible for completing triage calls 50% of the work week, 20 hours per week or approx. 3-5 calls per shift. Responsible for direct supervision and support of assigned nurses in their day-to-day operations 50% of the work week, 20 hours per week. Act as a resource for day-to-day questions for assigned nurses and as backup to management when not available or when clinical expert is needed. Organize and provide shift coverage for day-to-day nurse call ins. Monitor assigned nurse call volume. Make recommendations for action plans to improve management as needed. Provide feedback for...

The Advocacy 24/7 Triage Nurse provides telephonic first aid to injured workers on a case-by-case basis using nationally recognized standards of care to facilitate treatment goals.  The position is an essential role, requiring the ability to work a variety of shifts to cover 24/7 duties including evenings, nights, weekends and holidays. This is a remote role, candidates must reside in a nursing compact state. This role requires internet upload and download speeds of at least 80Mbps.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides telephonic assessment and makes treatment recommendation of injured workers using national telephonic triage protocols Recommends appropriate provider, based on state law and employer’s preferred provider network requirements Educates caller on self-care instructions in accordance with national telephonic triage protocols Communicates plan of care to customer contacts and/or supervisor Evaluates injured worker’s response to...