About The Position

This role involves providing telephone triage for members, assessing their health status, and directing them to the most appropriate level of care. The Triage Nurse will utilize assessment skills and evidence-based guidelines to evaluate members, including those with behavioral health challenges. The position also involves educating patients, acting as a patient advocate, and providing information about benefits and services. Effective management of telephone interactions, crisis situations, and accurate documentation are key aspects of this role. The nurse will also stay updated on healthcare trends and participate in departmental activities.

Requirements

  • Associates degree in Nursing required.
  • Three (3) years progressive clinical experience as an RN required.
  • Current, unrestricted RN licensure in state of practice required.
  • Strong computer skills.
  • Strong clinical assessment skills.
  • Strong 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.

Nice To Haves

  • Bachelor's degree in Nursing preferred.
  • Triage, Emergency Nursing, Critical Care, or acute care experience within the past 3 years is strongly preferred.
  • Behavioral Health experience preferred.
  • Telephone Triage in a call center setting preferred.
  • Multi-state RN licensure preferred.
  • Ability to obtain licensure by endorsement in non-compact states when applicable.

Responsibilities

  • 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 patients about their health conditions, treatment options, and preventive care measures.
  • 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.
  • 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.
  • Manage crisis situations effectively, providing appropriate resources and referrals to callers in distress.
  • 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.
  • Provide support during times of emergent or critical staffing needs.
  • Performs any other job related duties as requested.

Benefits

  • Bonus tied to company and individual performance.
  • Substantial and comprehensive total rewards package.

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

Associate degree

Number of Employees

11-50 employees

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