Triage Nurse I - CareBridge - Virtual

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading. Improving health means more than just treating what ails us – it means addressing the physical, behavioral and social drivers that impact whole health. Grounded in our mission and fueled by our bold and ambitious purpose to improve the health of humanity, we are committed to making whole health a reality for our consumers, their families, and our communities.

Seeking candidates who have an active, unrestricted RN Compact license or Multi-state RN licenses in either of the following states: AZ, FL, IA, IN, KS, MA, NM, OH, TN, TX or VA. Carebridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. Carebridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community based services Location: Virtual This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Work Shift: 11am - 9pm or 1pm - 11pm (Central Standard Time) The RN will work eight (8)10-hour work shifts, in a two-week period which includes Saturday and Sunday every other weekend. The Triage Nurse I - Carebridge is responsible for determining the appropriate Care Management program for members referred through internal and external sources and various data sources and reports. Utilizing department guidelines, completes triage process and applies established criteria to assign members to appropriate care management component. Deals with least complex cases having limited or no previous Triage care experience.

Utilizes the nursing process to meet an individual’s health needs, utilizing plan benefits and community resources. Educates members about contracted physicians, facilities and healthcare providers. Learn to develop favorable working partnerships and collaborative relationships with members, physicians, healthcare service providers, and internal and external customers to help improve health outcomes for members. Works in collaboration with medical management and care management associates to identify issues, problems, and resource needs and assign to appropriate care management program. Facilitates selecting appropriate candidates for referral to CM and/or DM. Partners with social work as appropriate. Identifies and refers cases or issues to QI, SIU, Subrogation, Underwriting, or other departments as appropriate. Documents appropriate clinical information, decisions, and determinations in a timely, accurate, and concise manner. Develops a working knowledge of member benefits, contracts, medical policy, professional standards of practice, and current health care practices.