Telephonic Nurse Case Manager (Remote)

About the Role

We're seeking a Telephonic Nurse Case Manager to join our growing team at Davies North America. In this full-time, home-based position, you'll monitor, evaluate, and coordinate high-quality, cost-effective medical treatment and health services under Workers' Compensation law. Reporting to the Case Management Supervisor, you'll ensure timely recovery, reduce recovery time, and minimize injury effects.

Responsibilities

• Provide telephonic case management in a Workers' Compensation environment, focusing on medical appropriateness of care, cost savings, and return-to-work status.
• Facilitate communication between employees, employers, insurers, healthcare providers, and rehabilitation consultants.
• Provide progressive education to injured employees and document in the system.
• Identify barriers to recovery and formulate plans to overcome them.
• Clinically evaluate recovery needs, assess health and medical records, and develop alternative treatment plans as necessary.
• Track protocol management for appropriate utilization and delivery of medical services.
• Serve as a patient advocate, adhering to legal, ethical, and accreditation/regulatory standards.
• Exhibit company values: Dynamic, Innovative, Connected, and Succeed Together.
• Perform other duties as assigned.

Requirements

• RN with 3-5 years clinical experience (medical-surgical, orthopedic, neurological, ICCU, industrial, or occupational).
• Possess one of the following certifications: CCRN, CCM, CDMS, COHN, COHN-S if managing a WC/MCO claim.
• At least 1 year of 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.
• Field case or catastrophic case management and utilization review experience preferred.
• Strong focus on cost containment while ensuring quality medical care.
• Knowledge of current trends, standards, and law changes.
• Self-directed and able to work independently.
• Proficient in personal computer and related claims/business software.
• Good communication skills, both oral and written.
• Team player with superb customer service skills.

Benefits

• Medical, dental, and vision plans.
• 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.

Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable laws.

Diversity and Inclusion

Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.

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

• Maintain regular and dependable attendance.
• Be available and able to perform job responsibilities during established work hours.

Any background check or review of criminal history, if applicable, will be conducted only after a conditional offer of employment and in compliance with applicable laws, including fair-chance hiring requirements.

Massachusetts Notice: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. Violators are subject to criminal penalties and civil liability.

AI Policy: At Davies, we value authentic conversations and a fair candidate experience. While candidates may use AI tools to prepare, we expect interview responses to reflect individual experience, knowledge, and judgment. We do not use Facebook, Craigslist, or Telegram for recruitment.