We’re on the lookout for a Telephonic Nurse Case Manager to join our growing team! As a Telephonic Nurse Case Manager, you will be responsible for monitoring, evaluating and coordinating the delivery of high quality, timely, cost-effective medical treatment and other health services under Workers’ Compensation law. Reporting to the Case Management Supervisor, you will also perform ongoing assessments of the injured employee’s recovery to ensure high quality of care, reduce recovery time and minimize the effects of injury.
This role is a full-time, home-based position.
Key Responsibilities
- Providing telephonic case management in a Workers’ Compensation environment while focusing on medical appropriateness of care to injured worker with cost savings by coordination and utilization of all services, ensuring that as soon as medically feasible, return-to-work status is achieved, along with increase in productivity
- Facilitating communication between the employee, the employee representative, employer, employer representative, insurer, health care provider, the medical services organization and when authorized, any qualified rehabilitation consultant, to achieve the goals
- Ensuring appropriate, progressive education is provided to the injured employee in a consistent manner while documenting in the system
- Identifying barriers to recovery and formulating a plan to overcome the barriers
- Clinically evaluating the recovery needs of an injured employee after the initial contact assessment and providing ongoing assessment of health and medical records
- Evaluating treatment plans while tracking and modifying appropriately, and documenting outcomes; developing alternative treatment plans as necessary
- Tracking protocol management for appropriate utilization and delivery of medical services
- Serving as a patient advocate adhering to all legal, ethical and accreditation/regulatory standards
- Exhibit company values of We are Dynamic, We are Innovative, We are Connected, and We Succeed Together
- Perform other duties as assigned
Skills, knowledge & expertise
- RN with 3-5 years clinical experience (medical-surgical, orthopedic, neurological, ICCU, industrial or occupational)
- Must possess one of the following certifications: CCRN, CCM, CDMS, COHN, COHN‐S if managing a WC/MCO claim
- At least 1 years’ experience handling Workers’ Compensation case management
- Proof of current State Licensure and eligible for endorsement in all other states
- Bi-lingual – fluent English/Spanish helpful
- Case-management experience mandatory – at least 1 year Workers’ Compensation
- Field case or catastrophic case management and utilization review experience is highly preferred
- Ability to demonstrate strong focus on cost containment to manage cases in most cost-effective way while still ensuring quality medical care
- Maintain knowledge of current trends, standards and law changes appropriate to the law at the date of injury
- 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
- Must be a team player with superb customer service skills
Equal Employment Opportunity & Legal Notices
- Medical, dental, and vision plans to support your health and that of your family
- A 401(k) plan with employer matching
- Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees
- Paid holidays
- Life insurance and short‑term and long‑term disability coverage
Compensation Transparency:
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.
Essential Functions
The following responsibilities and expectations are considered essential to the successful performance of this role. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform these essential functions.
- Maintain regular and dependable attendance.
- Be available and able to perform job responsibilities during established work hours.
Massachusetts Notice
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
At Davies, we value authentic conversations and a fair candidate experience. While candidates may use AI and technology tools to prepare for interviews, we expect interview responses and assessments to reflect each individual’s own experience, knowledge, and professional judgment.
We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at [email protected]
About Davies
We help our clients to manage risk, operate their core business processes, transform and grow. We deliver professional services and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation & risk, customer experience, human capital, digital transformation & change management.
Our global team of more than 8,000 professionals operate across ten countries, including the UK & the U.S. Over the past ten years Davies has grown its annual revenues more than 20-fold, investing heavily in research & development, innovation & automation, colleague development, and client service. Today the group serves more than 1,500 insurance, financial services, public sector, and other highly regulated clients.
