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Triage Nurse I - Carebridge - Virtual - Overnight

Determine appropriate care management programs for virtual patients overnight
Tennessee +50 Miles away from nearest Pulse Point, United States Tennessee Iowa New Mexico Texas Indiana
Junior
yesterday
Elevance Health

Elevance Health

A leading health benefits company providing insurance and healthcare services to improve lives and communities.

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Triage Nurse I - CareBridge - Virtual - Overnight

Carebridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. Carebridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community based services.

Work Location: Virtual

This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Work Shift: Overnight 10pm - 8am (Central Standard Time)

The RN will work eight (8) 10-hour work shifts, in a two-week period which includes Saturday and Sunday every other weekend.

The Triage Nurse I - CareBridge is responsible for determining the appropriate Care Management program for members referred through internal and external sources and various data sources and reports. Utilizing department guidelines, completes triage process and applies established criteria to assign members to appropriate care management component. Deals with least complex cases having limited or no previous Triage care experience.

Primary duties may include but are not limited to:

  • 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.

Position 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.

Preferred qualifications, skills, and experiences:

  • Current, active, RN Compact license highly preferred.
  • Emergency Room and/or Urgent Care experience highly preferred.
  • Telehealth experience.
  • 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.

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

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Triage Nurse I - Carebridge - Virtual - Overnight
Tennessee +50 Miles away from nearest Pulse Point, United States Tennessee Iowa New Mexico Texas Indiana
Registered Nurse
About Elevance Health
A leading health benefits company providing insurance and healthcare services to improve lives and communities.