Location Address: 9521 San Mateo NE , Albuquerque, New Mexico 87113-2237, United States of America
Compensation Pay Range:
Minimum Offer $:
27.92Maximum Offer for this position is up to $:
42.63Summary:
Build your Career. Make a Difference. Presbyterian is hiring a skilled IP Facility Coder III CCS to join our team.Sign on and relocation bonuses available for qualified candidates.
How you grow, learn and thrive matters here.Type of Opportunity:
PRNFTE:
0Job Exempt:
NoWork Shift:
Varied Days and Hours (United States of America)Job Description:
Presbyterian is seeking a Nurse Advice Line - Clinical Triage.
The Nurse Advice Line performs clinical triage and review of inbound member and patient calls to the PHP Nurse Advice Line to ensure that services rendered to customers meet clinically appropriate direction and triage. Utilizes clinical skills to coordinate, document, and communicate all aspects of the appropriate clinical advice and triage based on criteria and in adherence to adopted protocols. Clinical triage includes all levels of acuity of medical presentations. Assists callers and members with coordination of care to in plan providers and appropriate urgent and emergent care. Validates and interprets medical information from callers using evidence-based criteria sets. Consults with PHP medical directors on non-emergent cases where protocols are not clear. Refers callers of various acuities to venues of care-- including primary care, urgent or emergent care, ALS services, or public health services such as Poison Control Center or Public Health Department. May work varied shifts and performs occasional on-call assignments.
Some key responsibilities include:
Receives, triages, verifies, and processes requests for clinical triage and medical advice from health plan members and their representatives. Callers may have varying degrees of acuity in presentation and symptoms presented.
Uses clinical protocols to assess advice to callers, and documents discussion and information relayed.
May work with stakeholders and primary and specialty providers across the state to identify most appropriate direction of care based on call. Uses critical thinking to gauge risks, determine acuity of caller s situation and make evidence based decisions on information and advice provided.
Legally documents all calls and information discussed. Records and refers all pertinent information accordingly.
May collaborate with other resources such as behavioral health clinicians or crisis staff to best direct callers.
Advises manager of trends in calls and potential quality of care and legal issues.
Communicates effectively with providers, PHP medical directors, PCSC staff, and other applicable PHS departments to deliver sound and appropriate advice.
Qualifications:
Associates degree.
New Mexico Board of Nursing RN License with Multi-State Compact Licensure status required, with at least 3 years of RN experience in clinical setting, emergency medicine, urgent care, or managed care experience.
Experienced analytical skills as applicable to interpret medical records.
Experience with detailed research, coordination and organizational skills.
Demonstrated critical thinking skills as evidenced by experience, education, and/or the pre-hire interview process.
We're all about well-being, starting with yours.
Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.
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