About this role
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 an experienced Triage Telephonic Case Manager (RN) to join our Workers' Compensation managed care team. This role is responsible for providing clinical triage and telephonic case management services at the initial report of injury, ensuring injured employees receive appropriate, timely medical care while promoting recovery and return-to-work outcomes. The ideal candidate is a Registered Nurse with strong clinical assessment skills, workers' compensation knowledge, and the ability to make independent decisions in a dynamic, fast-paced environment. This position plays a critical role in the early intervention process, helping coordinate care, identify barriers to recovery, and advocate for injured workers while balancing client and regulatory requirements. Shift Availability: We currently have three openings available for this position, including two daytime shifts (9:00 AM - 6:00 PM) and one evening shift (2:00 PM - 11:00 PM) . Candidates must be able to work one of these schedules based on business needs and availability. Provide telephonic triage case management services at the onset of workers' compensation claims. Conduct comprehensive clinical assessments of injured employees at the time of injury and determine appropriate levels of care. Complete initial evaluations and required three-point contacts in accordance with state requirements and established protocols. Assess medical appropriateness of treatment and support timely access to care. Develop and implement initial case management care plans based on assessment findings. Coordinate communication among injured workers, employers, providers, claims professionals, and other stakeholders. Identify potential barriers to recovery and document findings for future case planning. Evaluate return-to-work capabilities and facilitate modified duty discussions when appropriate. Monitor treatment plans for compliance with state guidelines, evidence-based protocols, and client-specific requirements. Identify potential causation concerns and communicate findings to appropriate parties. Accurately document all assessments, contacts, medical information, and case activities within the claims management system. Serve as a patient advocate while maintaining compliance with all legal, ethical, and regulatory requirements. Support utilization management efforts through coordination of appropriate medical services and resources. Participate in quality assurance initiatives and departmental projects as assigned. Provide education and support to injured workers and their families throughout the recovery process. Assist in training claims personnel regarding medical case management opportunities and clinical considerations. Serve as a resource and mentor to team members as needed.