Triage Telephonic Nurse Case Manager

Our Story Imagine 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.

Davies North America is seeking a Triage Telephonic Case Manager (RN) to join our medical management team.

Compensation

claim, ensuring injured employees receive appropriate and timely medical care while supporting early return-to-work outcomes. This position requires strong clinical assessment skills, independent decision-making, and excellent communication to coordinate care between injured workers, employers, healthcare providers, and claims professionals.

claims. Perform clinical assessments of injured workers to determine appropriate medical care and treatment pathways. Complete initial assessment and required three-point contact in accordance with State of Florida procedures and emergency protocols.

Develop an initial case management care plan based on clinical findings and information obtained from the injured worker, employer, and medical provider. Identify potential causation concerns or barriers to recovery and document findings appropriately. Facilitate communication between injured workers, employers, claims professionals, healthcare providers, and rehabilitation specialists.

Monitor treatment plans to ensure adherence to state-mandated treatment guidelines and evidence-based medical protocols. Address initial return-to-work capabilities with injured workers and providers, documenting updates in the case management system. Maintain accurate and timely documentation of all contacts, interviews, and medical information in the claims management system.

Identify opportunities for cost-effective medical management and appropriate utilization of services. Educate injured workers and their families about recovery expectations and care plans. Maintain strict patient confidentiality and compliance with state and federal healthcare regulations.

Serve as a patient advocate, ensuring quality care and adherence to ethical and regulatory standards. Participate in quality assurance initiatives, committees, and department activities as required. Assist with training claims staff on identifying medical case management opportunities, as needed.

Registered Nurse (RN) with an active and unrestricted state license Minimum of 3 years of clinical nursing experience (medical-surgical, orthopedic, neurological, ICU/CCU, occupational health, or related specialty).

case management experience preferred. Prior telephonic case management or triage experience preferred. Strong understanding of clinical documentation and patient advocacy principles.

or occupational health environment.

medical case management practices and treatment guidelines. Ability to identify barriers to recovery and develop appropriate care strategies. Excellent verbal and written communication skills, with the ability to work collaboratively with multiple stakeholders.

Strong organizational and documentation skills with attention to detail. Ability to work independently and manage multiple priorities in a fast-paced environment. Proficiency with computer systems, case management software, and Microsoft Office applications.

Commitment to high-quality patient care, confidentiality, and regulatory compliance.

Benefits

At Davies North America, we are dedicated to supporting the well‑being and future of our qualifying employees.