Triage Nurse I – Carebridge – Bilingual
| Company | Elevance Health |
|---|---|
| Location | New Mexico, USA, Kansas, USA, Indianapolis, IN, USA, Iowa, USA, Texas, USA, Florida, USA, Arizona, USA, Tennessee, USA, Virginia, USA, Massachusetts, USA, Ohio, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | Associate’s |
| Experience Level | Junior, Mid Level |
Requirements
- Requires AS in nursing and minimum of 2 years of acute care clinical experience; or any combination of education and experience, which would provide an equivalent background.
- Current unrestricted RN license in the applicable state(s) required.
Responsibilities
- Utilizes the nursing process to meet an individual’s health needs, utilizing plan benefits and community resources.
- Educates members about contracted physicians, facilities and healthcare providers.
- Learn to develop favorable working partnerships and collaborative relationships with members, physicians, healthcare service providers, and internal and external customers to help improve health outcomes for members.
- Works in collaboration with medical management and care management associates to identify issues, problems, and resource needs and assign to appropriate care management program.
- Facilitates selecting appropriate candidates for referral to CM and/or DM.
- Partners with social work as appropriate.
- Identifies and refers cases or issues to QI, SIU, Subrogation, Underwriting, or other departments as appropriate.
- Documents appropriate clinical information, decisions, and determinations in a timely, accurate, and concise manner.
- Develops a working knowledge of member benefits, contracts, medical policy, professional standards of practice, and current health care practices.
Preferred Qualifications
- Current, active, RN Compact license highly preferred.
- Emergency Room and/or Urgent Care experience highly preferred.
- Telehealth experience.
- Bilingual Spanish is strongly preferred.
- Experience with EMR systems.
- BS in nursing preferred.
- Participation and/or certification in a managed care or utilization management organization preferred.
- Ability to understand clinical information and prepare a concise summary following department standards strongly preferred.
- Basic knowledge of the medical management and care management process and role preferred.