Imagine360 is seeking a Triage, RN to join the team! The Triage RN guides members throughout their healthcare experience by providing tailored support and clinical expertise. The nurse acts as an advocate for our members to help them utilize their health plan to the fullest potential. By educating members on resources and services available to them within their medical benefit plan, your support plays a key role in the member’s journey navigating through the complexity and cost of healthcare. The Triage RN performs symptom triage as well as various health assessments to prevent gaps in care. The nurse also assists our newest members to ensure a smooth transition into their health plan. Interactions with members will demonstrate an ability to understand and act upon a member’s needs to elevate the Member Experience.
Position Location: 100% remote
Responsibilities include but are not limited to:
- Hands on clinician in the triage process which could include but not limited to: perform real-time symptom triage and appropriate disposition and educational care instructions, using clinical knowledge to provide educational resources to members regarding their medical diagnosis, identify appropriate member referrals to Medical Management programs, resolve gaps in care for members.
- Maintaining monthly performance metrics.
- Utilize clinical knowledge, expertise, and Imagine360 approved educational resources to provide verbal and/or written educational resources to members regarding medical diagnosis, procedures and/or treatments.
- Perform real-time symptom triage to provide an appropriate disposition and educational care instructions, as needed.
- Review and assess current medical treatment and history to identify appropriate member referrals to Medical Management Programs and resolve any gaps in care.
- Collaborate proactively and effectively with members, peers, leadership, and all stakeholders to ensure a best-in-class service delivery.
- Accurate documentation in appropriate software in compliance with established Policy and Procedures.
- Adhere to established internal regulations regarding Department of Labor, HIPAA, PHI, ERISA and Medical Management Policy and Procedures.
- Resolve member complaints.
- Work scheduled shifts for coverage between the hours of 7:00am-9:00pm CST.
- Attend scheduled and periodic meetings, trainings and other job specific events as required by teleconference.
- Other duties as assigned.
Areas of Responsibility: Scope of Practice
- In addition to performing standard duties, the Registered Nurse is involved in clinical decision making and patient education. The scope of practice for nursing work includes, but is not limited to:
- Assessment and evaluation of the acquired clinical data to assess for appropriateness of treatment plan based upon Imagine360 clinical guidelines.
- Coordination of treatment plans, interventions, and outcome measurement.
- Provide patient education and educational resources.
- Rationale for the effects of medication and treatments.
- Accurately report:
- Client response
- Contact with other health care team members
- Administration of medication and treatments
- Respect the client’s right to privacy by protecting confidential information.
- Promote and participate in education and counseling to a participant based on health needs.
- Clarify any treatment that is believed to be inaccurate, non-efficacious, or contraindicated by consulting with appropriate practitioner.
Required Experience/Education:
- A nursing degree from an accredited college, university, or school of nursing.
- Active and unrestricted Registered Nurse License in eNLC compact state.
- 1+ years of clinical nursing experience, either experience in direct patient care (Hospital, Physician’s Office, or similar) or telephonic clinical care.
- Experience in a telephonic clinical role preferred.
Skills and Abilities:
- Excellent communication skills with personable and approachable demeanor and a passion for serving others.
- Team player who builds effective working relationships and able to handle multiple tasks & assignments.
- Proficient in typing and Office Software (Word, Excel, PowerPoint) and other programs such as Outlook, Internet Explorer, Database software, and standard office equipment.
- Ability to work independently in a home office environment.
- Ability to read and interpret documents such as HIPAA compliance, safety rules, operating and maintenance instructions, and policy & procedure manuals.
- Ability to draft professional communications and articulate complex ideas clearly in writing. Ability to write routine reports and correspondence.
- Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages. Ability to apply concepts of basic mathematics and accounting principles.
License and Certifications:
- Maintain active Registered Nurse license and CEU’s as required by the State Board of Nursing.
- Must be willing to obtain and maintain additional license(s) as required to perform the job functions of the organization within 18 months of employment.
What can Imagine360 offer you?
- Multiple Health plan options
- Company paid employee premiums for disability and life insurance
- Parental Leave Policy
- 20 days PTO to start / 10 Paid Holidays
- Tuition reimbursement
- 401k Company contribution
- Company paid Short & Long term Disability plus Life Insurance
- Professional development initiatives / continuous learning opportunities
- Opportunities to participate in and support the company’s diversity and inclusion initiatives
