Role Description
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team.
• Triage inbound calls, gather information, select appropriate triage guidelines, and disposition and care advice based on database protocols and department policies and procedures for a 24 hour per day/7 day a week operation.
• Provide clinical information and education for inbound and outbound calls providing oversight and support to the non-clinical staff.
• Conduct assessments of callers’ presenting symptoms.
• Develop, implement, and evaluate a plan of care for each caller presenting symptoms.
• Answer all calls in a timely manner.
• Maintain confidentiality of all caller and personnel issues.
• Document all call inquiries according to department policies and procedures.
• Participate in the collection of data for department quality projects.
• Promote recovery concepts and inspire hope.
• Possess and maintain a thorough grasp of clinical knowledge pertaining to various disease states, medications, treatments, etc.
• Comply with Federal and respective state’s laws regulating health management organizations and telephone information centers and all department standards and policies and procedures.
• Apply primary nursing knowledge while performing all aspects of assigned tasks.
• Perform other duties as assigned.
• Comply with all policies and standards.
Qualifications
• Graduate certificate from an accredited nursing program.
• 3+ years combined experience in critical care, pediatric, obstetrics, home health, school nursing, or emergency nursing.
• 5 years experience strongly preferred.
Requirements
• Registered Nurse (RN) State Licensure in the State of residence and Compact State Licensure required.
• Multiple State RN Licensures required.
• Texas Department of Family Service (DFPS) background required.
Benefits
• Competitive pay.
• Health insurance.
• 401K and stock purchase plans.
• Tuition reimbursement.
• Paid time off plus holidays.
• Flexible approach to work with remote, hybrid, field or office work schedules.