nursing backssment, prioritizes patient needs, and refers to the appropriate level of care that will ensure an optimal outcome. Provides comprehensive backssment and utilizes evidence based guidelines, along with insight of the nursing process, and a proven ability to critically analyze information from the patient and available medical records in the decision making process.
Ensures access to care. Serves as the primary point of contact for telephone patients with a variety of health-related question or concerns. Collects subjective data related to the presenting problem and medical history. Utilizes critical thinking and problem solving skills to recognize and match symptoms to protocol,
assigning acuity (emergent, urgent, acute and non-acute) and ensuring safe, timely disposition of health related calls. Documents encounter and decision making in a concise and accurate manner, utilizing the patient's own words as appropriate.
Recalls knowledge of the teaching principles of health care information to pediatric, adult and geriatric populations. Ensures that the caller comprehends health information and clinical advice to make informed healthcare decisions. Establishes an immediate therapeutic rapport with callers, making every effort possible to resolve the problem. Listens, communicates and documents simultaneously while navigating computer programs to backss, process,
educate and document all information in a professional manner.
Demonstrates knowledge and use of the nursing process to identify physical, psychosocial, and developmental needs and interventions to promote favorable outcomes. Meets established quality standards, competencies, and educational training and requirements. Participates in staff meetings, in-services, committees, and continuing education opportunities. Adheres to organizational and departmental policies, procedures, and established best practices. Demonstrates a commitment to patient centered care. Shifts may include alternating shifts and/or on call, or a combination. Proficiency at directing patients to various resources/knowledge of available patient resources, working with offices/staff to accommodate patient needs and working with afterhours/answering services to ensure patients are triaged appropriately and needs are met timely.
Proficiency at obtaining medical records, obtaining authorizations, and developing any skills necessary to expedite and facilitate access and allocation of patient services. Proficiency to navigate necessary databases and resources. Proficiency with navigation across diagnoses and treatments, as well as knowledge of applicable resources with ability to triage, document and assist appropriately patient appropriately.
Graduate from an accredited school of professional nursing Registered Nurse with 3 or more years of experience in a medical-surgical, primary care, pediatric, ED, case management, or clinical environment Skilled at navigating EMR preferably EPIC, MS Word, and prior job experience with typing and computer usage Bachelor's Degree in Nursing Certification in nursing specialty Telephone triage experience Expertise in crisis intervention, teaching/coaching, disease management and diagnostic monitoring It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, interaction, national origin, interactionual orientation/gender identity or any other category protected by applicable federal, state or local law.
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