Clinical Triage RN-ABQ

Presbyterian Healthcare Services • Pueblo, CO

1d • Onsite

About The Position

Performs clinical triage review of inbound member and patient calls to the Home HEALTH, HOSPICE, PALLIATIVE, Med & GYN ONC CSC Nurse Advice Line to ensure that services rendered to customers meet clinically appropriate direction and triage. Utilizes clinical skills to coordinate, document, and communicate all aspects of the appropriate clinical advice and triage based on criteria and in adherence to adopted guidelines and protocols. Clinical triage includes all levels of acuity of medical presentations. Assists callers and members with coordination of care to in plan providers, appropriate urgent and emergent care and Home Health, Hospice, Palliative, Med & GYN ONC services. Validates and interprets medical information from callers using evidence-based criteria sets. Consults with Medical Directors on non-emergent cases where protocols are not clear. Refers callers of various acuities to venues of care--including primary care, urgent or emergent care, ALS services, or public health services such as Poison Control Center or Public Health Department. May work varied shifts and performs occasional on-call assignments.

Requirements

• Associates degree required
• New Mexico Board of Nursing RN License with Multi-State Compact Licensure status required
• at least 3 years of experience in clinical setting, emergency, urgent care, or managed care experience
• Experienced analytical skills as applicable to interpret medical records.
• Experience with detailed research, coordination and organizational skills.
• Demonstrated critical thinking skills as evidenced by experience, education, and/or the pre-hire interview process.

Nice To Haves

• Bachelors preferred
• Experience in Nurse Advise Triage, Hospice, Home Health Care, Oncology and or Infusion centers preferred.

Responsibilities

• Receives triages, verifies, and processes requests for clinical triage and medical advice from health plan members and their representatives.
• Uses critical thinking to gauge risks, determine acuity of caller s situations and make evidence-based decisions on information and advice provided.
• Legally documents all calls and information discussed.
• Records and refers all pertinent information accordingly.
• May collaborate with other resources such as behavioral health clinicians, or crisis staff to best direct callers.
• Advises manager of trends in calls and potential quality of care and legal issues.
• Communicates effectively with providers, medical directors, and other applicable PHS departments to deliver sound and appropriate advice.
• Must adhere to protocols, guidelines and processes for compliance of call processing, documentation transfer and follow up.
• Meets departmental and/or regulatory turnaround times for clinical triage and internal Service Level Agreements (SLA) while maintain productivity and quality standards.
• Assists in orientation and training of new staff or students and serve as a resource person and professional role model.
• Performs other functions as required.

Benefits

• Educational and career development options, including tuition and certification reimbursement, scholarship opportunities
• Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern)
• Differentials for night/weekend shifts, higher education, certifications and various lead roles (for eligible positions)
• Malpractice liability insurance
• Loan forgiveness through the New Mexico Higher Education Department
• EPIC electronic charting system
• free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.

What This Job Offers

• Career Level: Mid Level
• Education Level: Associate degree