Telephonic Case Manager - RN

Join to apply for the Telephonic Case Manager I - RN role at Cor Vel Corporation.

The Telephonic Case Manager RN coordinates resources, develops cost-effective, personalized care plans for ill or injured individuals, and supports quality treatment and, when appropriate, a timely return to work.

Telephonic Case Manager RN uses clinical expertise to assess the appropriateness of current treatment plans based on the patient’s medical and physical condition. Telephonic Case Manager RN communicates directly with treating physicians to evaluate and recommend alternative care options when needed, explains medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of Cor Vel.

This is a remote position. All candidates must have an RN license. Obtaining an MN, WI, SD, and/or IA RN license may be required (if required, this cost is covered by Cor Vel).

• 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 patient's progress.
• Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness.
• Utilize medical and nursing knowledge to discuss the current treatment plan/alternate treatment plans with the physician.
• Make medical recommendations of available treatment plans to the payer.
• Implement care such as negotiating and coordinating the delivery of durable medical equipment and nursing services.
• Devise cost‑effective strategies for medical care.
• Prepare organized reports within a specified timeframe.
• Minimum productivity standard is 95% per month.
• Additional duties as assigned.

• Ability to make independent medical decisions and recommendations to all parties.
• Effective multi‑tasking skills in a high‑volume, fast‑paced, team‑oriented environment.
• Ability to interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers.
• Excellent written and verbal communication skills.
• Ability to meet designated deadlines.
• Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets.
• Strong interpersonal, time‑management, and organizational skills.
• Ability to work both independently and within a team environment.

• Bachelor’s degree required, BSN preferred.
• Graduate of accredited school of nursing.
• Current RN licensure in state of operation.
• 3 or more years of recent clinical experience, preferably in rehabilitation.
• URAC recognized Case Management certification (ACM, CCM, CDMS, CMAC, CMC, CRC, CRRN, COHN, COHN‑S, RN‑BC) required to be obtained within 3 years of hire if no nationally recognized certification is present at time of hire.
• Strong clinical background in orthopedics, neurology, or rehabilitation preferred.
• Strong cost containment background, such as utilization review or managed care helpful.
• Certification as a CIRS or CCM preferred.

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…