Telephonic Nurse Case-Manager – RN or LPN – Workers’ Comp

USIS/AmeriSys is looking for a Telephonic Case-Manager. Reporting to the Case Management Supervisor, you will be responsible for monitoring, evaluating and coordinating the delivery of high-quality medical treatment and other health services under Workers’ Compensation law. You will also perform ongoing assessments of the injured employee’s recovery to ensure high quality of care, reduce recovery time and minimize the effects of injury.

This role is a full-time, home-based position.

What You’ll Be Doing:

• Providing telephonic case-management in a Workers’ Compensation environment. Focusing on medical appropriateness of care to injured worker with cost savings by coordination and utilization of all services, ensuring that as soon as medically feasible, return-to-work status is achieved, along with increase in productivity.
• Facilitating communication between the employee, the employee representative, employer, employer representative, insurer, health care provider and other involved parties to achieve the goals, ensuring excellent customer relationships and quality customer service.
• Clinically evaluating the recovery needs of an injured employee after the initial contact assessment.
• Ensuring education is provided to the injured employee.
• Providing ongoing assessment of health and medical records.
• Developing case management care plan.
• Addressing the return-to-work capability with the injured worker and provider at each medical evaluation.
• Managing the file proactively, utilizing all appropriate case management tools.
• Identifying the need for utilization review procedures to claims, such as triggers that might indicate a potential barrier to recovery.
• Anticipating health needs during case-management process and educating the patient and family appropriately. Encouraging the injured worker to participate in the recovery plan.
• Serving as a patient advocate adhering to all legal, ethical and accreditation/regulatory standards.
• Performing other duties as needed.

What You’ll Need:

• RN or LPN with a minimum of three years clinical experience (medical-surgical, orthopedic, neurological, ICCU, industrial, ER or occupational).
• Proof of current Florida Licensure.
• Case-management experience desired – Workers’ Comp preferred.
• 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.

What We Offer:

• Generous Paid Time Off, plus Floating Holiday, Culture Day and 10 regular company-paid holidays.
• Generous benefits package, including medical, dental vision, life insurance, etc.
• 401(k) plan with company match
• Compensation: $60,000 to $80,000, based on license and experience.

Who We Are:

At Davies, we get it... you are not just looking for a job, you are looking to build a life and a career. We believe in our people and realize that our success is a direct result of creating a learning atmosphere, leadership opportunities, and promoting from within. We believe that engaging in corporate social activities and working together as a team is a vital part of the Davies culture.

With a multinational global team, Davies Group is a specialist professional services and technology firm working in partnership with leading insurance, highly regulated, and global businesses. At Davies Group, we help clients to manage risk, operate core business processes, and to transform and grow. We deliver operations, consulting and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation, customer experience, human capital, transformation, and change management.

As part of Davies Specialty Programs, USIS/AmeriSys specializes in Third Party Claims Administration and Medical Management for Workers’ Compensation and Liability claims. We pride ourselves on our friendly, team-orientated work environment. Our energetic team, supportive leaders, and can-do attitude enhance a sense of collaboration and belonging in our teammates.

Our focus is on quality, professional, superior service. This service-driven philosophy, conveyed throughout the organization, means we operate with the customers’ best interests at heart, constantly reinforcing our mission – Service Beyond the Contract.

Davies is committed to being a diverse and inclusive workplace. We welcome candidates of all genders, gender identity and expression, neurodiversity, sexual orientation, disability, physical appearance, body size, race, age, nationality, and belief (or lack thereof).

Application Deadline: February 22, 2024