Job Summary: The Triage Nurse is responsible for using decision support software to perform telephonic clinical triage and health information service for CareSource managed health plans and external clients. Essential Functions: Utilize assessment skills and evidence-based triage guidelines for triage of healthy, as well as acutely or chronically ill or injured members, including pediatric, adult, maternity, and geriatric members. Utilize provided training, skills and evidence-based triage guidelines to assess and assist members experiencing behavioral health challenges and crises. Function as patient advocate by facilitating accessibility to healthcare and provide linkage to other CareSource departments. Educate members to assist them in making informed decisions regarding personal healthcare. Assess health status and direct members to the most appropriate level of care. Utilize critical reasoning in clinical decision-making. Inform callers of preventative healthcare measures due. Identify and refer appropriate members for Care Management. Provide information about benefits, services and programs that allows members to maximize healthcare resources, as needed. Manage telephone interactions with compassion and respect for cultural, educational and psychosocial differences of individuals. Utilize multiple computer applications to document all information in an accurate manner. Practice in compliance with AAACN, URAC and NCQA standards and regulatory requirements. Keep abreast of trends in healthcare delivery and managed care. Participate in departmental activities such as quality audits, preceptorship/training as needed. Maintains and contributes to a collaborative professional and ethical work environment. Perform any other job duties as requested.
Education and Experience: RN license required. Bachelor's Degree in Nursing preferred. Minimum of three (3) years progressive clinical experience as an RN is required. Triage, Emergency Nursing, Critical Care, or acute care experience is preferred; experience within the past 3 years is strongly preferred. Behavioral Health experience is preferred. Telephone Triage in a call center setting preferred.
Competencies, Knowledge and Skills: Strong computer skills. Strong clinical assessment skills. Strong communication skills. Ability to work independently and within a team environment. Attention to Detail. Critical listening and thinking skills. Decision making/problem solving skills. Proper phone etiquette. Customer service oriented. Broad base of clinical knowledge. Teaching skills. Ability to remain calm under pressure and in member life threatening situations. Ability to apply multiple communicative skills while utilizing available tools and resources simultaneously. Exemplify CareSource's Mission in our behavior and member interactions.
Licensure and Certification: Current, unrestricted RN licensure in state of practice is required; multi-state licensure is preferred. Ability to obtain licensure by endorsement in non-compact states when applicable.
Working Conditions: General office environment; may be required to sit or stand for extended periods of time. Compensation Range: $61,500.00 - $98,400.00.
...what you do at Cardinal Health, you make a difference. Our warehouse team members make it all happen. You will receive and fulfill... ...We are open to candidates with little to no warehouse experience. If you are comfortable working in a fast-paced, goal-oriented...
...deadlines. Expert Sleuth - You are curious, dynamic, and proactive. Understanding that investigative work is part of daily life as a recruiter, you are well versed in exploring real and virtual networks and are not afraid to pick up the phone to learn more about potential...
...BJC HealthCare is seeking a Registered Nurse (RN) PCU - Progressive Care Unit for a nursing job in Valley Park, Missouri.Job Description... ...staff that promote the provision of a superior patient experience for patients and their families. Coordinates and manages house...
...Job Description Golden Brands is Now Hiring Merchandisers in Truckee, CA!\nImmediate Openings in Truckee, CA \nEarn $22.50 per Hour + Overtime - $3,500 Sign-On Bonus \n\n Our Merchandising Team supports our Sales & Delivery Departments by ensuring our products...
...Harrisburg, PA 17120), Commonwealth of PA - PennDOT - TEST2 A4 SC1 (QA Tester) - 764081 Looking for QA Tester with relevant experience in... ...ERP and CRM are second to none. Our industry-leading flagship product iMathSmart is re-defining math learning experience for school...