Telephonic Nurse Case Manager – Workers’ Comp Expert

Davies; United States; Remote; USD 75,000 - 105,000; Full time

Benefits offered by this job

Medical, dental, and vision plans

401(k) plan with employer matching

Paid time off

Paid holidays

Life insurance and disability coverage

Paid sick leave

Job summary

Davies North America is seeking a Telephonic Nurse Case Manager to manage medical claims in a Workers’ Compensation setting. You will perform telephonic case-management across the continuum of care, focus on medical appropriateness, and coordinate services to promote timely return-to-work for injured employees.

The role requires an RN with at least three years of clinical experience and a minimum of one year in Florida WC case management, plus active state licensure.

Qualifications

• RN with a minimum of three years clinical experience (medical-surgical, orthopedic, neurological, ICCU, industrial or occupational).
• At least one year’s experience handling Florida Workers’ Compensation case management.
• Proof of current State Licensure.
• Bilingual – fluent English/Spanish helpful.
• Case-management experience mandatory – 1 year Florida Workers’ Compensation.
• Maintains knowledge of current trends, standards and law changes.
• Must be self directed and able to work independently.
• Ability to effectively operate a personal computer and related claims and business software.
• Good communication skills, both oral and written. Team player. Good attendance.

Responsibilities

• Provide telephonic case-management in a Workers’ Compensation environment.
• Focus on medical appropriateness of care to injured worker with cost savings by coordination and utilization of all services.
• Facilitate communication between the employee, employer, insurer, providers and other stakeholders to achieve return-to-work goals.
• Clinically evaluate the recovery needs of an injured employee after initial assessment and incorporate information from employer and provider.
• Identify barriers to recovery and formulate an action plan to overcome these barriers.
• Provide ongoing assessment of health and medical records.
• Monitor health providers for licensure and quality of care.
• Monitor vendor performance and ensure quality service.
• Develop case management care plans and adjust as needed.

Skills

RN

Case management

Communication skills

Education

State Licensure

Job description

Davies North America is seeking a Telephonic Nurse Case Manager to manage medical claims in a Workers’ Compensation setting. You will perform telephonic case-management across the continuum of care, focus on medical appropriateness, and coordinate services to promote timely return-to-work for injured employees.

The role requires an RN with at least three years of clinical experience and a minimum of one year in Florida WC case management, plus active state licensure.