Medical Case Manager

Cor Vel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Huron, South Dakota or surrounding.

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, the insurance adjuster, medical providers, members of our team, and others. This is a local position that requires travel and is responsible for working with a caseload of workers compensation injured workers within a defined jurisdiction.

• Provides Medical Case Management to individuals through in person and telephonic communications with the patient, physician, other health care providers, employer and others.
• Utilizes their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans.
• Evaluates patient’s treatment plan for appropriateness, medical necessity, and cost effectiveness.
• Collaboration and communication with the insurance adjuster, providing updates and ensuring all parties are aligned with case management goals and medical treatment plan.
• Provides assessment, planning, implementation and evaluation of patient’s progress.
• Attends doctors, other providers, home and in some cases, attorney’s visits.
• Attends hospital and/or long-term facility discharge planning conferences, et cetera for the purpose of determining appropriateness of care and developing an effective long-term care strategy. Initial home visit for initial evaluation.
• Implements care such as negotiation the delivery of durable medical equipment and nursing services.
• This role requires regular travel, dependent on the injured worker’s injuries and needs. The employee must be available for local travel up to approximately 60% of the work week/month

• Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment.
• Experience as a RN, in workers’ compensation case management is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred.
• Ability to meet with the patient, their physicians, other healthcare providers, attorneys, and advisors/clients and coworkers.
• A cost containment background, such as utilization review or managed care is helpful.
• Strong interpersonal, time management and organizational skills.
• Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets.
• Ability to work both independently and within a team environment.

• Graduate of accredited school of nursing.
• Current RN Licensure in state of operation.
• Certification as a CCM or other Case Management certifications are preferred or will be required to obtain within 3 years of hire.
• A valid driver’s license, reliable transportation, and ability to travel to assigned locations is required.

Cor Vel 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: $62,306 – $93,123

A list of our benefit offerings can be found on our Cor Vel website:
Cor Vel 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…