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Care Advocate Nurse, Multistate
CAREA011051 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
- 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
- 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
