Clinical Triage RN-ABQ

• Performs clinical triage review of inbound member and patient calls to the Home HEALTH, HOSPICE, PALLIATIVE, Med & GYN ONC CSC Nurse Advice Line to ensure that services rendered to customers meet clinically appropriate direction and triage. Utilizes clinical skills to coordinate, document, and communicate all aspects of the appropriate clinical advice and triage based on criteria and in adherence to adopted guidelines and protocols. Clinical triage includes all levels of acuity of medical presentations. Assists callers and members with coordination of care to in plan providers, appropriate urgent and emergent care and Home Health, Hospice, Palliative, Med & GYN ONC services. Validates and interprets medical information from callers using evidence-based criteria sets. Consults with Medical Directors on non-emergent cases where protocols are not clear. Refers callers of various acuities to venues of care--including primary care, urgent or emergent care, ALS services, or public health services such as Poison Control Center or Public Health Department. May work varied shifts and performs occasional on-call assignments. How you grow, learn and thrive matters here.
• Educational and career development options, including tuition and certification reimbursement, scholarship opportunities
• Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern)
• Differentials for night/weekend shifts, higher education, certifications and various lead roles (for eligible positions)
• Malpractice liability insurance
• Loan forgiveness through the  New Mexico Higher Education Department
• EPIC electronic charting system Type of Opportunity: PRN FTE: 0.00 Job Exempt: No Work

Varied Days and Hours

*Receives triages, verifies, and processes requests for clinical triage and medical advice from health plan members and their representatives. Callers may have varying degrees of acuity in presentation and symptoms presented. *May Work with stakeholders, primary and specialty providers across the state to; identify most appropriate direction of care based on call. Uses critical thinking to gauge risks, determine acuity of caller s situations and make evidence-based decisions on information and advice provided. *Legally documents all calls and information discussed.

Records and refers all pertinent information accordingly. *May collaborate with other resources such as behavioral health clinicians, or crisis staff to best direct callers. *Advises manager of trends in calls and potential quality of care and legal issues. *Communicates effectively with providers, medical directors, and other applicable PHS departments to deliver sound and appropriate advice. *Must adhere to protocols, guidelines and processes for compliance of call processing, documentation transfer and follow up. *Meets departmental and/or regulatory turnaround times for clinical triage and internal Service Level Agreements (SLA) while maintain productivity and quality standards. *Assists in orientation and training of new staff or students and serve as a resource person and professional role model. *Performs other functions as required.

*Associates degree required, Bachelors preferred. *New Mexico Board of Nursing RN License with Multi-State Compact Licensure status required, with at least 3 years of experience in clinical setting, emergency, urgent care, or managed care experience. *Experience in Nurse Advise Triage, Hospice, Home Health Care, Oncology and or Infusion centers preferred. * Organizational and Analytical

Experienced analytical skills as applicable to interpret medical records. Experience with detailed research, coordination and organizational skills. Demonstrated critical thinking skills as evidenced by experience, education, and/or the pre-hire interview process.

We're all about well-being, starting with yours. Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more. Learn more about our employee benefits.

About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Compensation Disclaimer The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs. We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services