Telephonic Nurse Case Manager – Triage

About the role

Davies North America is seeking an experienced Registered Nurse to provide telephonic triage and case management for workers' compensation claims. The role focuses on early clinical assessment, coordinating timely medical care, and supporting injured employees in their recovery and return‑to‑work journey.

Key responsibilities

• Provide telephonic triage and case management services at the onset of workers' compensation claims.
• Conduct comprehensive clinical assessments of injured employees and determine appropriate levels of care.
• Complete initial evaluations and three‑point contacts in line with state requirements and company protocols.
• Develop and implement initial care plans based on assessment findings.
• Coordinate communication among injured workers, employers, providers, and claims professionals.
• Identify and document barriers to recovery and potential causation concerns.
• Evaluate return‑to‑work capabilities and facilitate modified duty discussions.
• Monitor treatment plans for compliance with state guidelines, evidence‑based protocols, and client requirements.
• Document all assessments, contacts, medical information, and case activities in the claims management system.
• Support utilization management and participate in quality assurance initiatives.

Required profile

• Registered Nurse (RN) with strong clinical assessment skills.
• Knowledge of workers' compensation processes and regulations.
• Ability to make independent clinical decisions in a fast‑paced environment.
• Excellent communication and advocacy skills.
• Availability to work one of the specified shifts (day or evening).

Required skills