This position manages incoming member/patient calls to evaluate call purpose and acuity utilizing established protocols and nursing assessment. Recommends appropriate care disposition and follows up as necessary to promote positive outcomes for member/patient. This position also utilizes protocols to assess the situation and provides treatment recommendations, options and ultimate care resolution. This includes reviewing callers relevant health care information, as well as documenting the purpose, information and resultant disposition of the call. This position may provide education to the public or other health professionals and participate in continuous quality improvement projects. May also facilitate appropriate referrals to physicians, services, and facilities, and/or directs individuals to other departments or services that may meet the needs and treatment recommendations.
Evaluates member/patient call and needs following established protocols. Utilizes databases and best practice evidence available, as well as clinical judgment to determine purpose of the call. This also includes assessing the members status to provide appropriate direction toward resolution whether triaged to another source or treatment recommended.
Utilizes multiple databases and electronic health systems (EHR) to research member history to provide appropriate coordinated care. Determines the acuity of situation/needs and triage callers to the appropriate level of care or call resolution.
Effectively accesses symptom-based guidelines, as well as documents all calls for medical/legal purposes using appropriate tools. Documents assessment, planning, implementation and evaluation in a timely manner to ensure compliance with established policies and procedures. Documentation reflects objective/subjective data, nursing interventions and patients response and disposition plan.
Actively participates in quality assurance and improvement processes to deliver excellent customer service to callers.
Considers the patient/members physical, cultural, psychosocial, and spiritual and age specific needs when planning care or direction toward treatment or call resolution.
Monitors member needs and proactively connects members with the appropriate services or contacts other departments or locations to assist with coordination of care of the patient.
Must possess knowledge as normally obtained through the completion of a Bachelor's degree in nursing or related field.
Must possess a current, valid RN license in state of practice, temporary RN license in state of practice, or compact RN licensure for current state of practice. Additional certification or continuing education may be required based on area of practice.
Requires a proficiency level typically achieved with 5 years clinical experience. Requires excellent organizational skills and clinical knowledge regarding specialty care services, as well as care coordination of services, legal and financial aspects of diagnostic services and health services in specialty area. Must possess ability to make autonomous decisions utilizing excellent clinical judgment. Must possess highly effective interpersonal and communication skills. Must understand the principles of quality customer service. Requires effective communication and writing skills, good time management skills and knowledge of word processing and database software applications. Requires the ability to teach both clinical and non-clinical personnel regarding care and diagnostics services. Also requires a good understanding of process improvement.
Bachelors in nursing and/or recent telephone triage experience strongly preferred. Previous emergency nursing, pediatric nursing, maternal/child health, ambulatory, home health or critical care experience preferred. Bilingual ability a plus.
Additional related education and/or experience preferred.
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.