Job Description

025010 Clin Alli-CCAPC Position Summary: The Primary Care Triage Nurse functions as a key part of the primary care team through health maintenance and chronic disease management, care coordination, and triage within the RN scope of practice. The Primary Care Triage Nurses utilizes the practice’s defined protocols and workflows to assess patient needs, decide on their disposition, dispense care advice, and escalate needs to other team members where appropriate. The Primary Care Triage Nurse acts as the patient’s primary point of clinical contact in the practice, and takes all incoming calls when routed by admin. The Primary Care Triage Nurse makes outbound calls in order to do ED, hospital, facility discharge checks, follow up after an acute concern, or help the team close care gaps, manage chronic diseases, or coordinate care. The Primary Care Triage Nurse also acts as the primary liaison with Care Partnership when communicating care management needs. The Primary Care Triage Nurse may assist the APC (Advanced Practice Clinician) or physician with lab orders, referrals, and scheduling urgent care visits when needed. The Primary Care Triage Nurse reports to the Triage Nurse Supervisor and is under the general supervision of the Primary Care Manager and Clinical Director. Supervision Exercised: None Essential Duties and Responsibilities: Act as a part of a team for the delivery of primary care Primary telephonic contact person for clinical and care coordination needs. Evaluates and assesses health care needs utilizing established triage protocols and documented workflows. Escalates issues to APC/physician based on triage protocol disposition, documented workflows, or nursing judgment Maintains timely and accurate documentation Coordinate and schedule urgent medical appointments. Provide telephonic education to patient and family regarding chronic disease management and follow-up, preventive health maintenance. Primary point of contact with Care Partnership in coordinating health plan activities. Coordination of referrals, specialty visits, testing, social services, skilled services. Communicate and follow up with skilled services like VNA on new/routine orders, chronic disease management. Assists administrative staff in identifying VNA vendors when needed. Performs telephonic follow-up of inpatient and ED care as delegated by the APC/physician. Attend team meetings and huddles to provide input on member care and receive action items as delegated by the APC/physician. Utilizes nursing judgement and/or provider order in order to refer to internal and external auxiliary resources such as CCA clinical group CHW, Rehab, Nursing and APCs, home based lab services, instEd, CGW Field Team, pharmacies, etc. Takes a primary role in coordinating gap closure activities. Assists with logistical planning for vaccination efforts or other clinical initiatives. Assists the APC/physician with submitting lab orders and follow-up as delegated. Completes other duties as assigned by Clinical Manager. Have a commitment to observing, reporting, and enhancing patient and employee safety as part of an overall emphasis on continuous improvement, learning, and member experience in the organization Working Conditions: This is a fully remote position. There may be rare requirements to travel to a site such as for in person meetings or trainings. Required Education: Associate degree or Diploma in nursing required Desired Education: Bachelor’s Degree in nursing preferred. Required Experience: Meaningful clinical experience including: 3+ years’ experience as Registered Nurse in a high touch clinical environment or home care, OR 2+ years caring for patients/members with complex medical, behavioral health, and social needs Required Knowledge, Skills & Abilities: Capacity to function independently within licensed scope of practice. Critical clinical thinking skills required. Excellent communication skills, i.e., listening, oral and written English skills while conversing Must have the ability to handle stressful emergency situations calmly and effectively with patients, families, and health professionals Must have the ability to de-escalate situations Must have the ability to effectively work with patients with various cognitive, physical, and behavioral abilities. Willing to learn and utilize telehealth technologies (video, chat, etc.), when appropriate, for a variety of clinical care and care management services. Language(s): English Bilingual Preferred Other: Laptop, Monitor, Headset, phone, Microsoft office, ShoreTel, Skype for Business, Guiding Care, ECW, all programs that are related to documentation. Standard office environment EEO is The Law Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws. Commonwealth Care Alliance

Job Tags

Similar Jobs