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(Archived) RN Case Manager

Last Updated: 10/21/19

Job Description

Position: Field Case Manager​
Location: Houston, TX
Duration: 12 Weeks

Job Details

  • Handle escalation of flagged claims regarding medication usage by claim, using clinical modelling data of Morphine Equivalency and Pharmacy Risk scores to ensure the needs of CorVel’s clients and their claimants are met
  • Ensure short-term use adherence for pain medications. Work with treating prescribers, nurse case managers and adjusters to explore and recommend alternative pain solutions on a case-by-case basis, flagging those cases signaling possible dependency issues
  • Work with the Formulary Support team to define, update and support the standard workers’ compensation and auto formularies
  • Review prior authorization requests for non-formulary medications
  • Requires continuous learning using relevant knowledge, keeping up-to-date with new medications/therapies and upcoming brand to generic changes. Provides an overall plan and assist in the conversion of brand and combination drugs to their generic, singular components
  • Increase the return rate of Letters of Medical Necessity by contacting the prescribers and being the contact person for clinical questions. Also assists in reviewing Letters of Medical Necessity

Requirements

  • Bachelor’s degree required, BSN desirable
  • Graduate of accredited school of nursingExc
  • Current RN Licensure in state of operation
  • Experience with PBM (Pharmacy Billing Management Software) is a plus
  • Background or have previously worked in drug management, pain management clinics, Pharmacy Techs/Nurses is a plus

Benefits

  • Entry-level medical opportunity with excellent training
  • Competitive salary commensurate with experience
  • Medical/Dental
  • Weekly Pay
  • Direct Deposit
  • Referral Bonuses
  • Childcare reimbursement

For immediate consideration please create a profile and submit your resume through our applicant tracking system. Applications with attached resumes will be given first consideration. Visit us online at [Register to View] to learn more about our company and to view additional openings in your area.

About Us: All Medical Personnel is a national leader in healthcare staffing and recognized by Staffing Industry Analysts (SIA) as one of the nation's largest healthcare staffing firms. Our team of seasoned recruiters are experienced in their ability to recruit, screen and place medical professionals for all types of healthcare settings.

Company Details

Irving, Texas, United States
Three Decades of Healthcare Staffing and RecruitingFor almost 30 years, All Medical Personnel has been the partner of choice for healthcare companies seeking clinical and non-clinical human capital solutions. Our success stems from understanding our partners’ strategic, financial, and operational goals, as well as providing exceptional talent and extraordinary service every day. Our clients incl...