Telephonic Nurse Case Manager (LPN or RN)

Telephonic Nurse Case Manager (LPN or RN)

Department: Claims Administration & Adjusting

Employment Type: Permanent - Full Time

Location: Home United States

Compensation: $70,000 - $80,000 / year

Description

Our StoryImagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.
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. 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. 

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

• LPN or RN with a minimum of three years clinical experience (orthopedic, neurological, neuromuscular, ICCU, industrial or occupational)
• At least one (1) year of …