As our Triage Nurse, you will be responsible for conducting a focused assessment and prioritizing a patient’s clinical condition to provide immediate care if the patient requires it.
Core Responsibilities include:
- Assess injury severity, the extent of disability, treatment plans, functional abilities, and physical job requirements.
- Utilize sound clinical judgment, careful listening, and critical thinking and assessment skills.
- Assign files appropriately to an Injury Coordinator or a TCM, based on the injured worker’s needs.
- Assist with tracking high-risk, high cost and complex patients by assessing the injured/disabled individual’s needs.
- Post case facts in Rising’s system, as well as the client’s claims system when appropriate.
- Assist non-clinical staff by reviewing files and recommending an action plan.
- Provide care direction and/or assist the injured worker in finding a provider when appropriate.
- Establish collaborative relationships and work as an intermediary between clients, patients, employers, providers, and attorneys.
- Adhere to quality standards along with state and national standards and guidelines
- Locate and document appropriate evidence-based and return-to-work guidelines (e.g., ODG).
- Promote quality, cost-effective care throughout the health continuum to ensure the injured/disabled individual can return to an optimal level of work and functioning.
- Advise the supervisor of any potential problems as they become evident.
- Maintain in-depth knowledge of all company products and services as well as customer issues and needs through ongoing training and self-directed research.
- Continuous professional development about issues and trends in case management.
- Provide input for policies/procedures, as requested.
- Adhere to departmental case management standards and guidelines, as well as Company policies, procedures, and reporting requirements.
- Perform other administrative or corporate duties upon request
Reports to:
Rising Ultimate Nurse Case Manager
Requirements
- Active appropriate professional nurse license (RN or LPN) in the state of residence
- Minimum of 1-year clinical nursing experience required
- Prior remote/telephonic work experience preferred
- Being bilingual in Spanish is a plus
- Prior triage experience preferred
- Experience with Workers’ Compensation, short-term or long-term disability, or liability claims preferred
- Bill review experience with Workers’ Compensation, Auto, and/or Health Insurance carriers a plus
- Flexibility in working both autonomously and on a team
- Maintain confidentiality of all information, policies, and procedures
- Demonstrate sensitivity to culturally diverse people and situations
- Well-developed time-management, organization, and prioritization skills
- Knowledge of utilization management, case management, and healthcare provided throughout the health continuum
- Excellent oral and written communication skills, over the phone and interpersonal
- Ability to gather data, compile information and, prepare summary documentation
- Strong interpersonal and customer service skills
- Experience in a fast-paced, multi-faceted environment
- Demonstrated persistence and attention to detail
- Working knowledge of internet research/navigation, Microsoft Word, Excel, and Outlook
- Ability to remain calm during stressful situations
- Customer-service oriented
Working Conditions:
- Remaining in a seated position
- Entering text or data into a computer
- Visual Acuity
- Talking
- Hearing
- Repetitive arm, hand, and finger motion
- Working remotely some or all of the time
Benefits
- Health insurance (6 different plans to choose from)
- Dental
- Vision
- Paid time off (PTO) or Flexible Time Off (FTO)
- 401(k)
- Basic Life Insurance and Long-Term Disability Insurance (paid by the company)
- Voluntary Life Insurance and Short-Term Disability Insurance
- Flexible Spending Accounts (FSA)
- Employee Assistance Program (EAP)
- Rise Well Wellness Program
- Professional Development Reimbursement Program (PDRP)
- You will be part of our new Elevate program designed to recognize and reward employees for their hard work
