Telephonic Nurse Case Manager - FL RN License (Remote)

Davies • Home, WV

40d • $70,000 - $83,000 • Remote

About The Position

The Telephonic Nurse Case Manager manages workers’ compensation medical claims and independently assesses and coordinates care for injured employees. The role monitors, analyzes, and evaluates treatment and other health services to support high-quality, timely, and cost-effective care, promote an appropriate return to work when medically indicated, and reduce recovery time and the effects of injury. Case-management activities must follow performance standards and parameters required by the State of Florida.

The position is remote and reports to the NCM Supervisor. It involves coordinating with treating providers, claims adjusters, employers, and injured workers; supporting modified-duty and return-to-work opportunities; and documenting case activity and clinical updates. The listed compensation range is $70,000–$83,000 per year.

Requirements

• Active and unrestricted Registered Nurse (RN) license.
• At least 3 years of clinical nursing experience, such as medical-surgical, orthopedic, neurological, ICCU, industrial, or occupational nursing.
• Strong clinical assessment and decision-making skills.
• Knowledge of medical case-management practices within workers’ compensation programs.
• Excellent communication and collaboration skills.

Nice To Haves

• Workers’ compensation case-management or occupational health experience.

Responsibilities

• Coordinate and monitor medical treatment for injured workers involved in workers’ compensation claims.
• Review medical records, treatment plans, and diagnostic reports to assess the appropriateness of care.
• Provide clinical recommendations regarding treatment plans, medical progress, and anticipated recovery timelines.
• Communicate with treating physicians and medical providers to clarify treatment plans and facilitate appropriate care.
• Partner with claims adjusters to provide clinical insight supporting claim evaluation and resolution.
• Assist adjusters in understanding medical conditions, treatment plans, and disability status.
• Participate in claim reviews and strategy discussions for complex or high-exposure claims.
• Work with employers and injured workers to support modified-duty and return-to-work opportunities.
• Evaluate functional capacity and work restrictions in collaboration with treating providers.
• Monitor treatment plans to ensure care is reasonable, necessary, and aligned with evidence-based guidelines.
• Maintain detailed and accurate documentation of case-management activities.
• Prepare case summaries, progress reports, and clinical updates for claims teams and stakeholders.
• Maintain regular and dependable attendance and be available to perform responsibilities during established work hours.

Benefits

• Medical, dental, and vision plans.
• 401(k) plan with employer matching.
• Discretionary Time Off (DTO) for exempt employees or Paid Time Off (PTO) for non-exempt employees.
• Paid holidays.
• Life insurance.
• Short-term and long-term disability coverage.
• Where required by law, paid sick leave, paid family and parental leave, and other mandated benefits.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed