medical case manager

Crawford & Company

<div>Now Hiring: RN Case Manager &ndash; New Jersey, US Region
 Work from home + local field travel 
 Salary: $75,000 &ndash; $85,000 annually 
 Quarterly Bonus Opportunities 
 Free CEUs for licenses &amp; certificates 
 License &amp; Certification Reimbursement
We&rsquo;re looking for an RN with a passion for case management to join our team! 
✨ RN degree required 
✨ National Certification preferred (CCM, CRC, COHN, CRRN) 
✨ Workers&rsquo; Comp Case Management experience a plus
✅ Your Impact: You&rsquo;ll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You&rsquo;ll support patients/employees receiving benefits under insurance lines including Workers&rsquo; Compensation, Group Health, Liability, Disability, and Care Management.
This is your chance to grow your career, earn great rewards, and enjoy true work-life balance.
 Apply today and make an impact in the community!<ul>
<li>Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services.</li>
<li>Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW.</li>
<li>Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention.</li>
<li>May perform job site evaluations/summaries to facilitate case management process.</li>
<li>Facilitates timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with injured worker, employer and physicians.</li>
<li>Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual.</li>
<li>May obtain records from the branch claims office.</li>
<li>May review files for claims adjusters and supervisors for appropriate referral for case management services.</li>
<li>May meet with employers to review active files.</li>
<li>Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians.</li>
<li>Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly.</li>
<li>May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases.</li>
<li>Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product.</li>
<li>Reviews cases with supervisor monthly to evaluate files and obtain directions.</li>
<li>Upholds the Crawford and Company Code of Business Conduct at all times.</li>
<li>Demonstrates excellent customer service, and respect for customers, co-workers, and management.</li>
<li>Independently approaches problem solving by appropriate use of research and resources.</li>
<li>May perform other related duties as assigned.</li>
</ul><ul><li>Associate's degree or relevant course work/certification in Nursing is required; BSN Degree is preferred.</li><li>
Minimum of 1-3 years diverse clinical experience and one of the below:</li><li>
Certification as a case manager from the URAC-approved list of certifications (preferred);</li><li>
A registered nurse (RN) license.</li><li>
Must be compliant with state requirements regarding national certifications.</li><li>
General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services.</li><li>
Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation.</li><li>
Excellent analytical and customer service skills to facilitate the resolution of case management problems.</li><li>
Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes.</li><li>
Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees.</li><li>
Demonstrated ability to gather and analyze data and establish plans to improve trends, processes, and outcomes.</li><li>
Excellent organizational skills as evidenced by proven ability to handle multiple tasks simultaneously.</li><li>
Demonstrated leadership ability with a basic understanding of supervisory and management principles.</li> 
<li>
Active RN home state licensure in good standing without restrictions with the State Board of Nursing.</li><li>
Must meet specific requirements to provide medical case management services.</li><li>
Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is preferred. If not attained, must plan to take certification exam within proceeding 36 months.</li><li>
National certification must be obtained in order to reach Senior Medical Case Management status.</li><li>
Travel may entail approximately 70% of work time.</li><li>
Must maintain a valid driver's license in state of residence.</li></ul>
#LI-RG1
Why Crawford?
 
 
Because a claim is more than a number &mdash; it&rsquo;s a person, a child, a friend. It&rsquo;s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community &ndash; one claim at a time.
 
 
At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We&rsquo;re looking for the next generation of leaders to take this journey with us.
 
 
We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com.
 
 
When you accept a job with Crawford, you become a part of the One Crawford family.
 
 
Our total compensation plans provide each of our employees with far more than just a great salary
 
<ul><li>Pay and incentive plans that recognize performance excellence</li>
<li>Benefit programs that empower financial, physical, and mental wellness</li>
<li>Training programs that promote continuous learning and career progression while enhancing job performance</li>
<li>Sustainability programs that give back to the communities in which we live and work</li>
<li>A culture of respect, collaboration, entrepreneurial spirit and inclusion</li>
</ul>Crawford &amp; Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford &amp; Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.</div>

Medical Case Manager

<div>Now Hiring: RN Case Manager &ndash; Grand Rapids, MI Region
 Work from home + local field travel 
 Salary: Competitive &amp; commensurate with experience 
 Quarterly Bonus Opportunities 
 Free CEUs for licenses &amp; certificates 
 License &amp; Certification Reimbursement
We&rsquo;re looking for an RN with a passion for case management to join our team! 
✨ RN degree required 
✨ National Certification preferred (CCM, CRC, COHN, CRRN) 
✨ Workers&rsquo; Comp Case Management experience a plus
✅ Your Impact: You&rsquo;ll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You&rsquo;ll support patients/employees receiving benefits under insurance lines including Workers&rsquo; Compensation, Group Health, Liability, Disability, and Care Management.
This is your chance to grow your career, earn great rewards, and enjoy true work-life balance.
 Apply today and make an impact in the community!<ul>
<li>Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services.</li>
<li>Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW.</li>
<li>Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention.</li>
<li>May perform job site evaluations/summaries to facilitate case management process.</li>
<li>Facilitates timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with injured worker, employer and physicians.</li>
<li>Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual.</li>
<li>May obtain records from the branch claims office.</li>
<li>May review files for claims adjusters and supervisors for appropriate referral for case management services.</li>
<li>May meet with employers to review active files.</li>
<li>Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians.</li>
<li>Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly.</li>
<li>May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases.</li>
<li>Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product.</li>
<li>Reviews cases with supervisor monthly to evaluate files and obtain directions.</li>
<li>Upholds the Crawford and Company Code of Business Conduct at all times.</li>
<li>Demonstrates excellent customer service, and respect for customers, co-workers, and management.</li>
<li>Independently approaches problem solving by appropriate use of research and resources.</li>
<li>May perform other related duties as assigned.</li>
</ul><ul><li>Associate's degree or relevant course work/certification in Nursing is required; BSN Degree is preferred.</li><li>
Minimum of 1-3 years diverse clinical experience and one of the below:</li><li>
Certification as a case manager from the URAC-approved list of certifications (preferred);</li><li>
A registered nurse (RN) license.</li><li>
Must be compliant with state requirements regarding national certifications.</li><li>
General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services.</li><li>
Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation.</li><li>
Excellent analytical and customer service skills to facilitate the resolution of case management problems.</li><li>
Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes.</li><li>
Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees.</li><li>
Demonstrated ability to gather and analyze data and establish plans to improve trends, processes, and outcomes.</li><li>
Excellent organizational skills as evidenced by proven ability to handle multiple tasks simultaneously.</li><li>
Demonstrated leadership ability with a basic understanding of supervisory and management principles.</li> 
<li>
Active RN home state licensure in good standing without restrictions with the State Board of Nursing.</li><li>
Must meet specific requirements to provide medical case management services.</li><li>
Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is preferred. If not attained, must plan to take certification exam within proceeding 36 months.</li><li>
National certification must be obtained in order to reach Senior Medical Case Management status.</li><li>
Travel may entail approximately 70% of work time.</li><li>
Must maintain a valid driver's license in state of residence.</li></ul>
#LI-RG1
Why Crawford?
 
 
Because a claim is more than a number &mdash; it&rsquo;s a person, a child, a friend. It&rsquo;s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community &ndash; one claim at a time.
 
 
At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We&rsquo;re looking for the next generation of leaders to take this journey with us.
 
 
We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com.
 
 
When you accept a job with Crawford, you become a part of the One Crawford family.
 
 
Our total compensation plans provide each of our employees with far more than just a great salary
 
<ul><li>Pay and incentive plans that recognize performance excellence</li>
<li>Benefit programs that empower financial, physical, and mental wellness</li>
<li>Training programs that promote continuous learning and career progression while enhancing job performance</li>
<li>Sustainability programs that give back to the communities in which we live and work</li>
<li>A culture of respect, collaboration, entrepreneurial spirit and inclusion</li>
</ul>Crawford &amp; Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford &amp; Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.</div>

Quality Comprehensive Health Center

Under the supervision of the Director of Client Services, the Medical Case Manager provides assessments of eligibility, health systems navigation, case management and education to clients seeking HIV care services through Quality Comprehensive Health Center (QCHC) who are Ryan White eligible. Patient Navigation/Case Management services will support QCHC to better serve those disproportionately at risk for or living with HIV by improving their access to medical care.Essential Duties and Responsibilities (other duties may be assigned):<ul><li>Provide patient navigation.</li><li>Coordinate patient scheduling for all providers.</li><li>Coordinate appropriate patient referrals to both internal and external agencies after patient appointments.</li><li>Assist patients as they move through the service delivery system.</li><li>Assist with the elimination of barriers including, but not limited to, insurance, financial and transportation.</li><li>Educate patients and others about HIV disease process and prevention.</li><li>Coordinate and maintain an active caseload of HIV patients.</li><li>Conducts intake interviews, performs psychosocial assessment to identify psychosocial, economic or social risk factors, performs eligibility and referral services for patient to ascertain support service needs associated with adherence to medical treatment plan.</li><li>Utilizes Motivational Interviewing techniques to identify client motivation and address barriers to change.</li><li>Links patient to a broad range of services, including, but not limited to medical care, behavioral health, substance abuse treatment, financial assistance, housing, food, financial entitlement, clothing, transportation, vocational training, and harm reduction services.</li><li>Completes all required documents for client services according to agency policies and funding source contracts under supervisor's direction. Monitors and accurately documents patients progress through individualized service planning that assesses level of functioning, adherence to medical treatment plan and access to service needs utilizing the Electronic Health Record (EHR) within defined time frame.</li><li>Act as a liaison between patient and all relevant professionals, programs, and resources to facilitate interdisciplinary care.</li><li>Monitors the progress of each need area as identified in the care plan and facilitate achievement of the service plan goals. Demonstrates initiative in maintaining contact with clients to update service needs assessments.</li><li>Develops and maintains strong relationships with community resources to maintain up-to date awareness of available resources.</li><li>Adheres to agency, state and federally (HIPAA) mandated regulations regarding confidentiality of HIV/AIDS care and services.</li><li>Attends/participates in all mandatory case management training and meetings.</li><li>Attends additional training opportunities as agency budget allows or as directed.</li><li>Stays informed about trends and developments in HIV service delivery, treatment, and substance use research.</li><li>Assist with, and coordinate, community education and outreach initiatives as requested.</li><li>Perform effectively within the organization and interpersonally with co-workers.</li><li>Develop positive working relationships with other social service, medical and mental health providers.</li><li>Other duties as required.</li></ul>Skills Required:<ul><li>Previous Ryan White experience preferred.</li><li>Experience using CAREWare preferred.</li><li>Experience assisting clients with Medicaid applications preferred</li><li>Strong organizational skills to manage caseload independently required</li><li>Basic knowledge of HIV, STis, PrEP and other prevention methods</li><li>Experience working in a clinical setting</li><li>Proactive problem solver who works well in multi-disciplinary setting</li><li>Ability to communicate well with medical providers and support staff</li><li>Strong verbal and written communication skills</li><li>Strong socio-cultural identification or work experience with MSM and LGBTQ+ preferred</li><li>Comfort discussing sexual health and risk reduction strategies</li><li>Proven organizational skills with high attention to detail</li><li>Intermediate to advanced level experience using Microsoft Office Suite</li><li>Ability to work well with diverse populations</li><li>Ability to work well within the organizational structure</li></ul>Minimum Qualifications:Bachelors or Masters Degree in Social Work or Health/Human Services required2+ years case management experience requiredEMR experience preferredJob Type: Full-timePay: Up to $50,000.00 per yearBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Flexible spending account</li><li>Health insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Application Question(s):<ul><li>Do you hold at least a Bachelor&rsquo;s or Master&rsquo;s degree in Social Work or a related Health or Human Services field, as typically required for this position? If yes, please list your degree and area of study below.</li></ul>Education:<ul><li>Bachelor's (Required)</li></ul>Experience:<ul><li>HIV case management: 2 years (Preferred)</li><li>Ryan White: 2 years (Preferred)</li><li>Case management: 2 years (Required)</li></ul>Work Location: In person

CorVel Corporation

<div>CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in the Macon/Warner Robbins, GA area.

Work from home, and on the road. Monday &ndash; 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.

Must be a registered nurse. Must have national certification &ndash; CCM, COHN, CRRN, CDMS.

ESSENTIAL FUNCTIONS &amp; RESPONSIBILITIES:
<ul>
<li>Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer, and the referral source</li>
<li>Utilizes their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans</li>
</ul><ul><li>Provides assessment, planning, implementation, and evaluation of patient&rsquo;s progress</li>
<li>Evaluates patient&rsquo;s treatment plan for appropriateness, medical necessity, and cost effectiveness</li>
</ul><ul><li>Attends doctors, other providers, home and in some cases, attorney&rsquo;s visits</li>
<li>Attends hospital and/or long-term facility discharge planning conferences, etc. for the purpose of determining appropriateness of care and developing an effective long-term care strategy</li>
<li>Conducts home visit for initial evaluation</li>
<li>Implements care such as negotiating the delivery of durable medical equipment and nursing services</li>
<li>This role requires regular travel, dependent on the injured worker&rsquo;s injuries and needs. The employee must be available for local travel up to approximately 60% of the work week/month</li>
<li>This role may require overnight travel</li>
<li>Additional duties as required</li></ul> 


KNOWLEDGE &amp; SKILLS:
<ul>
<li>Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment</li>
<li>Ability to meet with the patient, their physicians, other healthcare providers, attorneys, advisors/clients, and coworkers</li>
<li>A cost containment background, such as utilization review or managed care is helpful</li>
<li>Strong interpersonal, time management, and organizational skills</li>
<li>Computer proficiency and technical aptitude with the ability to utilize Microsoft Office, including Excel spreadsheets</li>
<li>Ability to work both independently and within a team environment</li></ul> 


EDUCATION &amp; EXPERIENCE:
<ul>
<li>Experience as an RN Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred</li>
</ul><ul><li>Graduate of accredited school of nursing</li>
<li>Current RN Licensure in state of operation</li>
<li>Certification as a CCM, CIRS, or other Case Management certifications preferred</li>
<li>A valid driver&rsquo;s license, reliable transportation, and ability to travel to assigned locations is required</li></ul> 


PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $63,739 - $95,264

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. 


ABOUT CORVEL &ndash; Medical Case Managers:

CorVel, a certified Great Place to Work&reg; Company, is a national provider of industry-leading risk management solutions for the workers&rsquo; 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&rsquo;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.

#LI-Remote</div>

Medical Case Manager I

<div>CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Reno, NV.
Work from home, and on the road. Monday &ndash; 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. 


ESSENTIAL FUNCTIONS &amp; RESPONSIBILITIES:
<ul>
<li>Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer, and the referral source</li>
<li>Utilizes their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans</li>
<li>Provides assessment, planning, implementation, and evaluation of patient&rsquo;s progress</li>
<li>Evaluates patient&rsquo;s treatment plan for appropriateness, medical necessity, and cost effectiveness</li>
<li>Attends doctors, other providers, home and in some cases, attorney&rsquo;s visits</li>
<li>Attends hospital and/or long-term facility discharge planning conferences, etc. for the purpose of determining appropriateness of care and developing an effective long-term care strategy</li>
<li>Conducts home visit for initial evaluation</li>
<li>Implements care such as negotiating the delivery of durable medical equipment and nursing services</li>
<li>This role requires regular travel, dependent on the injured worker&rsquo;s injuries and needs. The employee must be available for local travel up to approximately 60% of the work week/month</li>
<li>This role may require overnight travel</li>
<li>Additional duties as required</li></ul> 


KNOWLEDGE &amp; SKILLS:
<ul>
<li>Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment</li>
<li>Ability to meet with the patient, their physicians, other healthcare providers, attorneys, advisors/clients, and coworkers</li>
<li>A cost containment background, such as utilization review or managed care is helpful</li>
<li>Strong interpersonal, time management, and organizational skills</li>
<li>Computer proficiency and technical aptitude with the ability to utilize Microsoft Office, including Excel spreadsheets</li>
<li>Ability to work both independently and within a team environment</li></ul> 


EDUCATION &amp; EXPERIENCE:
<ul>
<li>Experience as an RN Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred</li>
<li>Graduate of accredited school of nursing</li>
<li>Current RN Licensure in state of operation</li>
<li>Certification as a CCM, CIRS, or other Case Management certifications preferred</li>
<li>A valid driver&rsquo;s license, reliable transportation, and ability to travel to assigned locations is required</li></ul> 


PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $65,436 &ndash; $98,982

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. 


ABOUT CORVEL &ndash; Medical Case Managers:

CorVel, a certified Great Place to Work&reg; Company, is a national provider of industry-leading risk management solutions for the workers&rsquo; 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&rsquo;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.

#LI-Remote</div>

Medical Case Manager II

HopeHealth, Inc.

<div>
 
 Overview Of Position
 
 
 
 Provides direct services to HIV+ clients and their families. Medical case management duties cover a wide spectrum of responsibilities that lead to satisfactory health outcomes for clients. Duties include assessments on new clients, reassessments, identifying problems and needs, and working with the clients to meet those needs. Works closely with the clinic staff in developing and carrying out a treatment plan / action plan for each client, advocates for the client and makes referrals to other providers as needed; reports directly to the Case Management Supervisor.
 
 
 
 Qualifications
 
 
 
 Must possess a minimum of a bachelor&rsquo;s degree in a human services field; will have the ability to work with clients from a wide range of backgrounds and lifestyles, while maintaining a non-judgmental attitude. Must possess strong documentation skills and the ability to handle multiple tasks. Will have the ability to work with clients from a wide range of backgrounds and lifestyles, while maintaining a non-judgmental attitude. Must be knowledgeable in computer software and hardware, data entry and reporting; must be multi-task oriented and be able to work independently or as part of a team; advanced degree preferred but not required.
 
 
 
 Physical Requirements
 
 
 
 Must have direct client contact in order to provide program activities, must be able to lift 50+ pounds, use of computer for long periods of time, must be able to sit, squat, lift and stand as needed, must be able to travel.
 
 
 
 Essential Job Functions
 
 
 
 I. Responsible for the management of a client caseload of up to 125 HIV+ persons:
 
 
 <ul>
 <li>
 Conducts a complete assessment of the client&rsquo;s health, mental health, financial situation, housing situation, legal, social, educational, employment status, etc. and designs a treatment plan based on the assessment.
 </li>
 <li>
 Assists clients in obtaining needed benefits such as Medicaid, disability, and food stamps.
 </li>
 <li>
 Helps clients obtain medications through the statewide ADAP and other drug assistance programs.
 </li>
 <li>
 Conducts housing assessments and completes HOPWA applications for clients as appropriate.
 </li>
 <li>
 Follows statewide case management guidelines in conducting home visits, re-assessments, mid year reviews and other required service standards.
 
 
 </li>
 </ul>
 II. Responsible for information exchange between organizations and making referrals as appropriate:
 
 
 <ul>
 <li>
 Makes referrals based on client&rsquo;s needs for mental health counseling, substance abuse counseling, housing or financial issues, CLTC, etc.
 </li>
 <li>
 Requests records from other organizations on behalf of the client. Integrates information into the Hope system (Provide) and files as appropriate.
 </li>
 <li>
 Responsible for the maintenance and overall organization of the client&rsquo;s record (CM paper chart and Provide record).
 
 
 </li>
 </ul>
 III. Responsible to educate the client and family members and advocate on their behalf for fair treatment:
 
 
 <ul>
 <li>
 Gives the client consistent and reliable HIV/AIDS information and shares with the family as deemed appropriate by the client.
 </li>
 <li>
 Makes calls on behalf of the client when another agency is not providing appropriate levels of care and attention. Works to reduce or eliminate discrimination in the areas of housing, employment and benefits programs.
 </li>
 <li>
 Stays current on HIV/AIDS related research and health information and maintains strong relationships with outside organizations.
 
 
 </li>
 </ul>
 IV. Responsible for the professional documentation of all services provided:
 
 
 <ul>
 <li>
 Completes progress logs and other Provide Software documentation in a timely manner.
 </li>
 <li>
 Documents use of time using agency approved forms and guidelines.
 
 
 </li>
 </ul>
 
 Responsibilities
 
 
 
 V. Responsible to assist with various special events:
 
 
 <ul>
 <li>
 Participates in the planning and implementation of agency fund-raisers (AIDSWALK, DWS, etc.).
 </li>
 <li>
 Assists with Holiday gift programs for clients.
 </li>
 <li>
 Identifies and recruits clients from caseload to participate on committees, workshops, community initiatives, etc.
 
 
 </li>
 </ul>
 VI. Other Duties as assigned.
 
 
 Quality Management / Reporting: Responsible for ensuring that organization maintains accurate data collection and documentation. Serves on quality management sub-committees as needed.
 
 
 
 Knowledge/ Skills
 
 
 
 <ul>
 <li>
 Experience with and thorough knowledge of Microsoft Office and Excel for report development and data analysis required. Must be familiar with HIV/AIDS disease processes. Be adept in utilizing basic software / data base applications.
 </li>
 <li>
 Ability to work in a high performance environment.
 </li>
 <li>
 Ability to take initiative and handle various tasks simultaneously while working efficiently, effectively, and independently under minimal supervision
 </li>
 <li>
 Possession of strong written and oral communications and problem solving skills required
 </li>
 <li>
 Ability to foster a team environment and motivate staff
 </li>
 <li>
 Ability to build and maintain productive working relationships with Clinic, Medical Case Management, Prevention, and Support Services Staff
 </li>
 <li>
 Valid Driver&rsquo;s License required Some non-traditional working hours may be required
 </li>
 <li>
 Participates in the planning and implementation of agency fund-raisers (AIDSWALK, DWS, etc.).
 </li>
 <li>
 Other Duties as assigned by CMS, DPS, other managers.
 </li>
 </ul>
</div>

<div>CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Folsom, CA.
Work from home, and on the road. Monday &ndash; 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. 


ESSENTIAL FUNCTIONS &amp; RESPONSIBILITIES:
<ul>
<li>Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer, and the referral source</li>
<li>Utilizes their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans</li>
<li>Provides assessment, planning, implementation, and evaluation of patient&rsquo;s progress</li>
<li>Evaluates patient&rsquo;s treatment plan for appropriateness, medical necessity, and cost effectiveness</li>
<li>Attends doctors, other providers, home and in some cases, attorney&rsquo;s visits</li>
<li>Attends hospital and/or long-term facility discharge planning conferences, etc. for the purpose of determining appropriateness of care and developing an effective long-term care strategy</li>
<li>Conducts home visit for initial evaluation</li>
<li>Implements care such as negotiating the delivery of durable medical equipment and nursing services</li>
<li>This role requires regular travel, dependent on the injured worker&rsquo;s injuries and needs. The employee must be available for local travel up to approximately 60% of the work week/month</li>
<li>This role may require overnight travel</li>
<li>Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (&ldquo;IIPP&rdquo;)</li>
<li>Additional duties as required</li></ul> 


KNOWLEDGE &amp; SKILLS:
<ul>
<li>Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment</li>
<li>Ability to meet with the patient, their physicians, other healthcare providers, attorneys, advisors/clients, and coworkers</li>
<li>A cost containment background, such as utilization review or managed care is helpful</li>
<li>Strong interpersonal, time management, and organizational skills</li>
<li>Computer proficiency and technical aptitude with the ability to utilize Microsoft Office, including Excel spreadsheets</li>
<li>Ability to work both independently and within a team environment</li></ul> 


EDUCATION &amp; EXPERIENCE:
<ul>
<li>Experience as an RN Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred</li>
</ul><ul><li>Graduate of accredited school of nursing</li>
<li>Current RN Licensure in state of operation</li>
<li>Certification as a CCM, CIRS, or other Case Management certifications preferred</li>
<li>A valid driver&rsquo;s license, reliable transportation, and ability to travel to assigned locations is required</li></ul> 


PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $32.18 - $48.68 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. 


ABOUT CORVEL &ndash; Medical Case Managers:

CorVel, a certified Great Place to Work&reg; Company, is a national provider of industry-leading risk management solutions for the workers&rsquo; 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&rsquo;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.

#LI-Remote</div>

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