About The Position

The Care Advisor is a licensed Registered Nurse who reports to the Clinical Services team. The role provides quality-driven telephonic clinical assessments, health education, and utilization management services to a diverse population of callers, patients, and members. Care Advisors perform triage assessments using telecommunications and computer-based algorithms, protocols, and guidelines, then use clinical knowledge and critical thinking to assess needs, determine appropriate dispositions, recommend care, and provide education and health information. This is a work-from-home role for applicants who reside in an eligible compact-licensure state and maintain an unrestricted compact multistate RN license. Full-time positions are available at 36–40 hours per week. Schedules are evenings and include at least two weekend days every two weeks; employees must work four weekend shifts per month. Differential pay may apply to certain shifts. Training lasts 2–4 weeks, with the first two weeks during daytime hours, and requires 100% attendance. Training is conducted in a virtual, interactive classroom. The home office must meet certification requirements explained during the interview process. Carenet Health is not authorized to hire in IL, AK, CA, MA, MI, MN, NY, NV, NJ, OR, RI, WA, WV, HI, CT, DE, VT, or Puerto Rico. Applicants must currently reside in one of the listed eligible compact states: AL, AR, CO, FL, GA, IA, ID, IN, KS, KY, LA, ME, MS, MO, MT, NE, NM, NC, ND, NH, OK, SC, SD, TN, TX, VA, WI, or WY.

Requirements

  • Current, unrestricted RN licensure in a compact state that is the applicant's state of residence; must maintain a compact multistate license.
  • Current home-state RN license in good standing.
  • Must currently reside in an eligible compact state and be able to obtain licenses in additional states as required.
  • Minimum of an associate degree from a two-year college or technical school, or a Diploma Nursing Program.
  • Minimum of 3 years of Registered Nurse clinical experience.
  • Must attend 100% of training hours and pass intra-training testing components.
  • Ability to apply clinical knowledge to meet clinical business standards.
  • Competence in product delivery and business requirements.
  • Ability to run multiple computer programs simultaneously.
  • Ability to identify improvement opportunities and recommend workable solutions.
  • Ability to exercise judgment within defined practices and procedures and determine appropriate action.
  • Ability to identify when issues should be escalated and escalate them in a timely manner.
  • Ability to build rapport with members and influence member behavior effectively.
  • Comprehensive listening, reflection, clarification, and communication skills.
  • Ability to manage time effectively.
  • Must meet home-office certification requirements for work-from-home positions.

Nice To Haves

  • Bachelor of Science in Nursing (BSN).
  • Experience in emergency care, adult and pediatric care, medical/surgical, home health, hospice, or other acute-care areas.
  • Telephone triage experience.
  • Understanding of health benefit plans and the insurance industry.
  • Bilingual skills.

Responsibilities

  • Provide nursing assessments within the standards outlined in the state Nurse Practice Act, using the nursing process.
  • Assess individuals or defined patient populations by telecommunications in accordance with computer-based algorithms, protocols, and guidelines.
  • Follow nursing standards, company policies, and shared principles when providing clinical assessments and health education.
  • Identify patient care needs, risks, safety issues, educational opportunities, and appropriate health care referrals using the nursing process.
  • Process calls in accordance with Quality Management guidelines.
  • Meet product-specific performance metrics.
  • Maintain regular, reliable attendance and punctuality.
  • Work four weekend shifts per month, either on an every-Saturday schedule or every other weekend.
  • Perform other duties as assigned.

Benefits

  • Health insurance
  • Dental insurance
  • Vision insurance
  • 401(k) plan with company match
  • Paid time off and holidays
  • Flexible spending accounts
  • Employee wellness programs
  • Career development opportunities
  • CEU subscription provided at hire
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