Job Summary :
- Evening hours - 3pm-1 : 30am - every other weekend, every other holiday
- Shift differential
The Triage Nurse is responsible for using decision support software to perform telephonic clinical triage and health information service for CareSource managed health plans and external clients.
Essential Functions :
Utilize assessment skills and the nursing process for care of healthy, as well as acutely or chronically ill or injured clients, including pediatric, adult, maternity, and geriatric membersFunction as patient advocate by facilitating accessibility to healthcare and provide collaborative service for other CareSource departmentsEducate members to assist them in making informed decisions regarding personal healthcareAssess health status and direct members to the most appropriate level of careUtilize critical reasoning in clinical decision-makingInform callers of preventative healthcare measuresIdentify and refer appropriate members for Case ManagementProvide information about benefits, services and programs that allows members to maximize healthcare resourcesAssess caller's needs and assists with issues related to member's careManage telephone interactions with compassion and respect for cultural, educational and psychosocial differences of individualsUtilize multiple computer applications to document all information in an accurate mannerPractice in compliance with AAACN,URAC and NCQA standards and regulatory requirementsKeep abreast of trends in healthcare delivery and managed careParticipate in self-managed team : daily operations, quality audits, preceptor / training resource, etc.Maintains and contributes to a collaborative professional and ethical work environment.Perform any other job duties as requestedEducation and Experience :
RN license requiredBachelor's Degree in Nursing preferredMinimum of three (3) years of progressive clinical experience is requiredTriage, Emergency Nursing or Critical Care experience is preferredBehavioral Health experience is preferredTelephone Triage in a call center setting preferredCompetencies, Knowledge and Skills :
Beginning level computer skillsClinical assessment skillsCommunication skillsAbility to work independently and within a team environmentAttention to DetailCritical listening and thinking skillsProper grammar usageProper phone etiquetteDecision making / problem solving skillsCustomer service orientedBroad base of clinical knowledgeTeaching skillsAbility to remain calm under pressure and in life threatening situationsAbility to multitask-simultaneously thinks, talks and typesUnderstand and support philosophy of HMO and managed healthcare programsLicensure and Certification :
Current, unrestricted RN licensure in state of practice is required; multi-state licensure is preferredAbility to obtain licensure by endorsement in non-compact states when applicableWorking Conditions :
General office environment; may be required to sit or stand for extended periods of timeCompensation Range :
55,350.00 - $88,560.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type : Hourly
Competencies :
Create an Inclusive Environment- Cultivate Partnerships- Develop Self and Others- Drive Execution- Influence Others- Pursue Personal Excellence- Understand the BusinessTrueCare is a Mississippi non-profit, provider-sponsored health plan formed by a coalition of Mississippi hospitals and health systems throughout the state and supported by CareSource's national leadership in quality and operational excellence. TrueCare offers locally based provider services through provider engagement representatives and customer care. Our sole mission is to improve the health of Mississippians by leveraging local physician experience to inform decision-making, aligning incentives, using data more effectively, and reducing friction between the delivery and financing of health care. By doing so, TrueCare will change the way health care is delivered in Mississippi.
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.
Salary : $55,350 - $88,560
