Offer summary

Qualifications:

Current RN license required, multi-state licensure preferred., Bachelor’s Degree in Nursing preferred., Minimum of three years of progressive clinical experience as an RN required, with preferred experience in Triage, Emergency Nursing, or Critical Care., Strong communication, clinical assessment, and decision-making skills are essential. .

Key responsibilities:

Perform telephonic clinical triage and health information service for members and clients.

Utilize assessment skills to direct members to appropriate levels of care and educate them on healthcare decisions.

Function as a patient advocate and facilitate access to healthcare resources.

Document interactions accurately and maintain compliance with healthcare standards.

Job description

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:

Beginning level computer skills
Clinical assessment skills
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

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Hourly

Organization Level Competencies