Telephonic Nurse Case Manager (Remote)

Davies
United States
Workplace: RemoteFull timeFunction: Healthcare (Clinical, Medical, Wellness)Experience: 3-5 yearsSkills: ["Self-directed","Independent work","Communication skills","Customer service","Teamwork","Cost containment focus"]

Provide telephonic case management for injured workers in a Workers’ Compensation environment, coordinating timely, high-quality, cost-effective medical treatment. Monitor and evaluate recovery progress, identify barriers, and develop education and care plans. Facilitate communication across employees, providers, insurers, and authorized consultants, while tracking protocol utilization and documenting assessments and outcomes to support return-to-work and productivity.

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Davies
Davies
2 days ago

Telephonic Nurse Case Manager (Remote)

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Last checked: 14 hours agoStatus: Live

Job Summary

Provide telephonic case management for injured workers in a Workers’ Compensation environment, coordinating timely, high-quality, cost-effective medical treatment. Monitor and evaluate recovery progress, identify barriers, and develop education and care plans. Facilitate communication across employees, providers, insurers, and authorized consultants, while tracking protocol utilization and documenting assessments and outcomes to support return-to-work and productivity.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: Healthcare (Clinical, Medical, Wellness)
Seniority: Mid level

Key Responsibilities

  • •Provide telephonic case management for Workers’ Compensation claims, focusing on medical appropriateness of care and cost savings through coordination and utilization of services.
  • •Facilitate communication among the injured employee, representatives, employer, insurer, health care providers, and authorized qualified rehabilitation consultants to achieve care goals.
  • •Conduct initial and ongoing clinical evaluations of recovery needs and review health/medical records to support appropriate, progressive education and assessment.
  • •Evaluate and track treatment plans, modify appropriately, and develop alternative treatment plans as needed while documenting outcomes.
  • •Serve as a patient advocate and maintain protocol management to ensure appropriate utilization and delivery of medical services, adhering to legal, ethical, and accreditation/regulatory standards.

Pay and Benefits

Perks:Health InsuranceDentalVision401kPaid LeavePaid HolidaysLife InsuranceDisability InsurancePaid Parental

Key Requirements

  • •RN with 3–5 years clinical experience (medical-surgical, orthopedic, neurological, ICCU, industrial or occupational).
  • •Hold one of the following certifications: CCRN, CCM, CDMS, COHN, or COHN-S (if managing a WC/MCO claim).
  • •At least 1 year of Workers’ Compensation case management experience; case-management experience is mandatory.
  • •Proof of current State Licensure and eligible for endorsement in all other states.
  • •Bilingual fluent English/Spanish helpful; ability to work independently and operate personal computer/claims and business software.
Experience:3-5 yearsWorkers’ CompensationHealthcare
Skills:Self-directedIndependent workCommunication skillsCustomer serviceTeamworkCost containment focus
Licenses:State Licensure
Certifications:CCRNCCMCDMSCOHNCOHN-S
Languages:EnglishSpanish

Company Brief

Davies
Davies is a specialist professional services and technology firm delivering claims, underwriting, and risk solutions to insurers, reinsurers, brokers and regulated businesses globally, with major capabilities in claims management, forensics, and digital transformation.
Industry: Consulting
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Established Company
Valuation: Unicorn (USD 1B+)
Funding: Private Equity Backed
Headquarters: City of London, United Kingdom
Founded: 1968
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Glassdoor: 3.8
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