CorVel in Santa Ana, CA is seeking a full time Utilization Review Case Management Manager. The Utilization Review Case Management Manager is responsible for directing the operations of their designated department, which may include one or more of the following functions: human resources, customer service, and sales management.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Responsible for directing a designated group of employees in their day-to-day operations.
- Responsible for quality of service provided.
- Responsible for human resources matters directly related to department managed.
- Requires regular and consistent attendance.
- Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
- May be required to travel overnight and attend meetings.
- May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses.
- May be responsible for marketing and sales activities.
- May be required to oversee case management clinical activities (dependent on whether or not unit manager is an RN)
- For Managers who are not RN’s, the clinical oversight and direction will be performed by a designated RN with a nationally recognized certification. This could be a case management supervisor, another manager or local executive.
- May perform case management responsibilities (dependent on whether or not unit manager is an RN for medical case management activities or qualified for vocational case management).
- Additional duties as required
KNOWLEDGE & SKILLS:
- Ability to write and speak clearly, easily communicating complex ideas across multiple platforms.
- Ability to remain poised in stressful situations and communicate diplomatically via telephone, computer, fax, correspondence, etc.
- Ability to skillfully manage multiple, complex projects and competing priorities concurrently while working under pressure to meet deadlines and maintaining strong customer service orientation.
- Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets
- Must have technical knowledge of the laws, policies, and procedures in defined territory.
- Strong interpersonal, time management and written communication skills.
- Great attention to detail, and results focused
- Graduate of accredited school of nursing with a diploma/Associates degree (Bachelor of Science degree or Bachelor of Science in Nursing preferred)
- Current RN licensure in state of operation.
- 3 or more years of recent clinical experience, preferably in rehabilitation.
- National certification (CRC, CIRS, CCRN, CVE, CCM, etc.), CCM preferred.
- Demonstrated experience in management or supervision.