Triage RN I - Acute, CareBridge (*Virtual*)

Elevance Health; Tampa (FL); Hybrid; USD 67,000 - 116,000; Full time

Job summary

Elevance Health is seeking a Triage Nurse I who will determine the appropriate Care Management program for referred members. The role handles less complex cases with strong nursing assessment and collaboration with care teams.

Flexible, virtual eligibility with in-person training sessions as needed. The position requires an AS in nursing and an unrestricted RN license in eligible states; BSN preferred and telehealth/EMR experience are highly regarded.

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.
• 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.

Responsibilities

• 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.

Skills

RN license

Telehealth

EMR systems

Nursing assessment

Education

AS in nursing

BSN preferred

Tools

EMR systems

Job description

Triage Nurse I

Seeking candidates who have an active, unrestricted RN Compact license or Multi-state RN licenses in any of the following states: AZ, FL, IA, IN, KS, MA, NM, OH, TN, TX, NJ, NY, HI or VA.

LOCATION: This position is virtual eligible.

SCHEDULE: Eight (8) 10-hour work shifts in a two week period which includes Saturday and Sunday every other weekend.

SHIFTS AVAILABLE:

11am - 9pm CST

1pm - 11pm CST

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.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Triage Nurse I 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 is 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.

Required 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.

Preferred Qualifications

• 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.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $67,200 to $115,920.

Locations: Cleveland, OH; Columbus, OH; Massachusetts; New Jersey; Hawaii, Virginia

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.

• The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state, and local 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 should submit the Accessibility Accommodation Request Form (https://forms.cloud.microsoft/pages/responsepage.aspx?id=8giMvgesLESaRuvu61vU17EJaA0EP3FIissI8zmZ_NpUNUgyTFRUMkY5NE5JNDFWMkhaUzQxMkJLWS4u&route=shorturl) and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration (https://info.flclearinghouse.com/) .