Remote Prior Authorization Rn Jobs in Edmond, OK

The Care Advocate Nurse oversees initiatives surrounding assessing the severity of the injured workers’ reported injury(ies), reviews medical data in CareMC, validates and secures medical information, assesses and evaluates prescribed treatment of work related injury. The Care Advocate Nurse functions as a nurse consultant, supporting the goals of the Claims Management department and of CorVel.

This is a remote role.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

• Initiates and receives telephonic contact with reported injured worker, employer and medical providers to obtain treatment plan, secures medical documentation, and assesses if injured worker has returned to work
• Responsible for detailed documentation within the claim system focusing on medical condition, treatment plan and return to work status
• Directs callers to appropriate medical and/or claim resources
• Identifies and communicates urgent situations related to treatment or patient condition directly to the claim team
• Functions as nurse consultant to the claim team
• Assesses appropriate medical follow-up and makes necessary recommendations to the claim team, working closely with team to assist in identifying potential red flags from the injury that may require further follow-up or additional services
• Adheres to the Care Advocate Nurse production standards and Account special handling guidelines
• Additional duties as assigned

KNOWLEDGE & SKILLS:

• Fundamental concepts, practices and procedures of early intervention in the field of Workers’ Compensation (WC)
• Excellent verbal and written communication skills
• Ability to skillfully manage multiple, complex projects and competing priorities concurrently while working under pressure to meet production standards deadlines and maintaining strong customer service orientation
• Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Outlook, Word, and Excel spreadsheets
• Strong interpersonal skills
• Great attention to detail, and results focused
• Ability to work independently and as part of a team

EDUCATION/EXPERIENCE:

• Minimum of 2 years' clinical nursing experience
• Graduate of an approved accredited school of nursing
• Current unencumbered RN Licensure in state of residency and practicing state(s) must be maintained throughout employment with CorVel

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: $61,053 - $98,334

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

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ 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.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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