Case Manager II

CorVel Corporation

. Gather demographic and clinical information on prospective, concurrent, and retrospective inpatient admissions and outpatient treatment .

Posted 11/2/2026full-timeRemote • California • United StatesMid-LevelSenior💰 $32 - $49 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in clinical assessment, utilization review, and effective communication within healthcare settings. Proficient in CPT and ICD coding, with a strong understanding of the workers’ compensation claims process and the ability to manage high-volume workloads.

Highest-signal resume keywords

Current Nursing LicensureCPT and ICD Coding KnowledgeUtilization Review ExperienceClinical Experience in OR, ICU, CCU, ER, or OrthopedicsEffective Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical AssessmentUtilization ReviewCPT CodingICD CodingData AnalysisDocumentationLength of Stay CertificationInpatient AdmissionsOutpatient TreatmentSafety Compliance

Soft Skills

Effective Organization SkillsTime ManagementInterpersonal SkillsTeam CollaborationIndependent Work

Tools & Technologies

Microsoft OfficeExcel Spreadsheets

Certifications & Qualifications

Associate’s Degree in NursingBachelor of Science DegreeBachelor of Science in Nursing

Industry Keywords

Workers’ Compensation Claims ProcessUtilization Review ServicesInjury and Illness Prevention ProgramClinical ExperienceProspective ReviewConcurrent ReviewRetrospective Review

About the role

Key responsibilities & impact

Gather demographic and clinical information on prospective, concurrent, and retrospective inpatient admissions and outpatient treatment
Certify medical necessity and assign an appropriate length of stay
Support the goals of the Case Management department and CorVel
Identify the necessity of the review process
Communicate issues of concern to appropriate claims staff and customers
Collect data and analyze information to decide on certification or denial of treatment
Document all work appropriately
Promote utilization review services with stakeholders
Comply with safety rules and regulations during work hours under the Injury and Illness Prevention Program
Perform additional duties as assigned

Requirements

What you’ll need

Graduate of an accredited school of nursing with an associate’s degree, Bachelor of Science degree, or Bachelor of Science in Nursing
Current nursing licensure in the state of operation required; RN required unless local state regulations permit LVN/LPN
4 or more years of recent clinical experience
Thorough knowledge of CPT and ICD coding
Ability to interface with claims staff, attorneys, physicians and their representatives, advisors/clients, and coworkers
Effective organization skills in a high-volume, fast-paced environment
Strong time management skills and ability to meet designated deadlines
Excellent written and verbal communication skills
Ability to work independently and within a team environment
Strong interpersonal skills
Ability to utilize Microsoft Office, including Excel spreadsheets
Knowledge of the workers’ compensation claims process preferred
Knowledge of outpatient utilization review preferred
Prospective, concurrent, and retrospective utilization review experience preferred
Experience in clinical areas of OR, ICU, CCU, ER and/or orthopedics preferred

Benefits

Comp & perks

Medical (HDHP) with Pharmacy
Dental insurance
Vision insurance
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
Paid time off
Career advancement opportunities
Supportive culture
Equal Opportunity Employer
Drug-free workplace