Triage Nurse I — Virtual Care Coordinator

Elevance Health; Indianapolis (IN); Remote; USD 67,000 - 116,000; Full time

Job summary

Elevance Health seeks a Triage Nurse I with an active RN license and acute care experience to determine appropriate care management programs for members referred from multiple sources. The role involves completing triage using department guidelines and applying criteria to assign members to the proper care management component.

Qualifications include AS in nursing and a minimum of 2 years of acute care experience, with preferred RN Compact license and telehealth or EMR experience.

Qualifications

• 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.
• BS in nursing preferred.
• Emergency Room and/or Urgent Care experience highly preferred.
• Telehealth experience encouraged.
• Participation and/or certification in a managed care or utilization management organization preferred.

Responsibilities

• Determines appropriate Care Management program for referred members.
• Completes triage process and assigns members to care management components.
• Deals with least complex cases with limited triage experience.
• Educates members about contracted physicians, facilities and providers.
• Develops partnerships with members, physicians, and providers to improve health outcomes.
• Identifies and refers cases to CM and/or DM.
• Documents clinical information, decisions, and determinations accurately.
• Develops knowledge of member benefits, contracts, and medical policy.

Skills

Nursing process

Telehealth experience

EMR systems

Education

AS in nursing

BS in nursing

Tools

EMR systems

Job description

Elevance Health seeks a Triage Nurse I with an active RN license and acute care experience to determine appropriate care management programs for members referred from multiple sources. The role involves completing triage using department guidelines and applying criteria to assign members to the proper care management component.

Qualifications include AS in nursing and a minimum of 2 years of acute care experience, with preferred RN Compact license and telehealth or EMR experience.