Triage Telephonic Nurse Case Manager; Remote

Department: Claims Administration & Adjusting

Employment Type: Permanent - Full Time

Location: Home United States

Reporting To: Medical MGMT Program Manager

Compensation: $66,000 - $67,000 / year

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.

The Triage Nurse Case Manager evaluates workers' compensation injury referrals to determine the appropriate level of medical case management intervention. This role reviews injury details and medical information to support early clinical decision-making and ensure appropriate case management services are assigned.

• Review injury referrals and medical documentation to assess case complexity and medical needs.
• Support assignment of appropriate case management services, including telephonic or field case management.
• Provide clinical guidance to claims teams regarding injury management strategies.
• Monitor triage workflow and referral turnaround times.
• Maintain documentation supporting triage decisions and case assignments.
• Support quality improvement initiatives related to triage processes and clinical outcomes.
• Serve as a clinical resource for nurse case managers managing complex or high-exposure claims.
• Partner with operational leadership to support effective triage service delivery.
• Participate in case reviews and audits to ensure recommendations align with evidence-based practices and program guidelines.
• Provides strategic oversight for triage case management programs.
• Oversees multiple teams or supervisory staff.
• Monitors operational performance, service delivery, and clinical outcomes.
• Identifies process improvement opportunities within triage operations.
• Partners with senior leadership on program initiatives and client deliverables.
• Supports workforce planning, staffing strategies, and resource allocation.
• Ensures alignment with organizational goals and clinical best practices.

• Registered Nurse (RN) with active and unrestricted license
• 3+ years of clinical nursing experience required (medical-surgical, orthopedic, neurological, ICCU, industrial or occupational)
• Workers' compensation case management or occupational health experience preferred.
• Strong clinical assessment and decision-making skills.
• Knowledge of medical case management practices within workers' compensation programs.
• Excellent communication and collaboration skills.

At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:

• Medical, dental, and vision plans to support your health and that of your family
• A 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 federal, state, and local laws, including those tied to an employee’s primary work location.

Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.

Davies is dedicated to fostering…