Job Description

Job Description

Job Description

Description

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.

What's in Store

Davies Claims North America is looking for an experienced Telephonic Nurse Case Manager to manage Workers’ Compensation claims ensuring timely and appropriate medical care is provided to injured workers while supplying medical information and making recommendations for compensability of claims. Reporting to the Nurse Case Manager Supervisor, you will telephonically screen and manage workers’ compensation medical claims, review medical documentation, prepare written correspondence, and communicate with physicians regarding major contributing causes of medical conditions as it relates to the reported accident.

 

To be successful in this role, you must demonstrate high-level attention to detail and problem-solving skills, strong organizational skills with the ability to multi-task and prioritize with excellent organization and documentation, as well as possess proven critical thinking skills while exhibiting analysis and judgement with sound decision making abilities. You must possess a valid Florida Registered Nurse license and must have 3 or more years of hospital, orthopedic, and/or Workers’ Compensation experience. Additionally, you will need to be proactive, independent, and take initiative with consistent follow through while exhibiting discretion with sensitive and confidential information. 

This role is hybrid, based in our Lakewood Ranch, FL office. There may be opportunities for remote work for well-qualified candidates.
Key Responsibilities

• Triage newly acquired claims to determine severity of reported injuries
• Provide medical information and make recommendations for compensability of claims
• Initiate contact with injured worker regarding medical management of the claim
• Work with medical providers to provide medical management to injured worker
• Review medical documentation, prepare written correspondence, and communicate with physicians regarding major contributing cause of medical condition as it relates to the reported accident
• Monitor medical treatment to ensure medical protocol is within recognized parameters
• Promptly authorize causally related medical services prescribed
• Coordinate light duty availability with medical providers and employers
• Communicate work status changes in a timely manner
• Prepare and approve pre-certifications
• Assist with medical management to obtain MMI
• Maintain working knowledge of Workers’ Compensation Statutes and Rules and their application
• Convey a positive attitude and teamwork for optimum provision of service to clients
• Review Permanent Impairment Rating for appropriateness
• Exhibit company values of We are Dynamic, We are Innovative, We are Connected, and We Succeed Together
• Perform other duties as assigned

Skills, knowledge & expertise

• Possess a valid Florida Registered Nurse license
• Substantial knowledge of medical terminology
• Demonstrate proficiency in Microsoft Office Suite programs
• Ability to travel and/or attend claim reviews as deemed necessary
• Proactive, independent, and takes initiative with consistent follow through
• Superb communication skills, verbal and written, conducted in a timely manner
• Superior time management skills with capability of working with and meeting deadlines
• Exceptional capability to multi-task and prioritize with excellent organization and documentation skills in a fast-paced, dynamic work environment
• Excellent team player with interpersonal skills
• High level attention to detail and problem-solving skills
• Capable of working collaboratively and independently with minimal supervision
• Exhibit discretion with sensitive and confidential information
• Display a comfort level working with key people at all levels within an organization

Preferred 

• 3+ years of hospital, orthopedic, and/or Workers’ Compensation experience
• Extensive knowledge of Workers’ Compensation Statutes, Rules, and case law
• NLC licensure (Compact License) highly desirable
• Certified Case Manager designation (CCM)

Benefits

Benefits

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 ensure your health and that of your family.
• A 401k plan with employer matching to help you build a secure financial future.
• Our time-off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
• Paid holidays.
• Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.

 

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.

Job Tags

Permanent employment, Temporary work, Work at office, Remote work,

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