[Hiring] Triage RN @Imagine360

Role Description Imagine360 is seeking a Triage RN to join the team! The Triage RN guides members throughout their healthcare experience by providing tailored support and clinical expertise. The nurse acts as an advocate for our members to help them utilize their health plan to the fullest potential. By educating members on resources and services available to them within their medical benefit plan, your support plays a key role in the member's journey navigating through the complexity and cost of healthcare. The Triage RN performs symptom triage as well as various health assessments to prevent gaps in care. The nurse also assists our newest members to ensure a smooth transition into their health plan. Interactions with members will demonstrate an ability to understand and act upon a member's needs to elevate the Member Experience. Position Location: 100% remote The schedule for this role is:

• Monday - Thursday: 12pm - 9pm CST
• Friday: 10am - 7pm CST
• (First 60 days training schedule: 8am - 5pm CST)

Responsibilities include but are not limited to:

• Hands on clinician in the triage process which could include but not limited to:
• Perform real-time symptom triage and appropriate disposition and educational care instructions, using clinical knowledge to provide educational resources to members regarding their medical diagnosis.
• Identify appropriate member referrals to Medical Management programs, resolve gaps in care for members.
• Maintaining monthly performance metrics.
• Utilize clinical knowledge, expertise, and Imagine360 approved educational resources to provide verbal and/or written educational resources to members regarding medical diagnosis, procedures and/or treatments.
• Perform real-time symptom triage to provide an appropriate disposition and educational care instructions, as needed.
• Review and assess current medical treatment and history to identify appropriate member referrals to Medical Management Programs and resolve any gaps in care.
• Collaborate proactively and effectively with members, peers, leadership, and all stakeholders to ensure a best-in-class service delivery.
• Accurate documentation in appropriate software in compliance with established Policy and Procedures.
• Adhere to established internal regulations regarding Department of Labor, HIPAA, PHI, ERISA and Medical Management Policy and Procedures.
• Resolve member complaints.
• Work scheduled shifts for coverage between the hours of 7:00am-9:00pm CST.
• Attend scheduled and periodic meetings, trainings and other job specific events as required by teleconference.
• Other duties as assigned.

Qualifications

• A nursing degree from an accredited college, university, or school of nursing.
• Active and unrestricted Registered Nurse License in eNLC compact state.
• 1+ years of clinical nursing experience, either experience in direct patient care (Hospital, Physician's Office, or similar) or telephonic clinical care.
• Experience in a telephonic clinical role preferred.

Requirements

• Excellent communication skills with personable and approachable demeanor and a passion for serving others.
• Team player who builds effective working relationships and able to handle multiple tasks & assignments.
• Proficient in typing and Office Software (Word, Excel, PowerPoint) and other programs such as Outlook, Internet Explorer, Database software, and standard office equipment.
• Ability to work independently in a home office environment.
• Ability to read and interpret documents such as HIPAA compliance, safety rules, operating and maintenance instructions, and policy & procedure manuals.
• Ability to draft professional communications and articulate complex ideas clearly in writing.
• Ability to write routine reports and correspondence.
• Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages.
• Ability to apply concepts of basic mathematics and accounting principles.

License and Certifications

• Maintain active Registered Nurse license and CEU's as required by the State Board of Nursing.
• Must be willing to obtain and maintain additional license(s) as required to perform the job functions of the organization within 18 months of employment.

Benefits

• Multiple Health plan options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Company paid Short & Long term Disability plus Life Insurance
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives

Company Description

Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions. Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation.