Registered Nurse – Triage and Transitions Team

This is a fully remote position, open to applicants in Colorado, +1 more state.

📋 Description

• Identify patients for proactive interventions by utilizing screening criteria, reviewing medical records, assessing payor models, evaluating medical risk scores, or processing referrals.

• Evaluate patients' medical, functional, and social circumstances to create personalized care plans, recommendations, or referrals.

• Coordinate both internal and external services addressing social determinants of health needs and community care.

• Review and adjust care plans and interventions based on their effectiveness and patient outcomes.

• Conduct remote nursing assessments employing critical thinking and evidence-based protocols to establish care recommendations.

• Encourage patient self-management and behavior modification through health coaching, care navigation, coordination, and education.

• Provide education to healthcare team members regarding transitions, triage processes, and referrals; inform patients about their conditions and self-management strategies.

• Collaborate with physicians and healthcare team members to guarantee timely, high-quality care and to resolve any delays or issues.

• Take part in rounds or case conferences and consult team-based resources such as social work, nutrition, pharmacy, rehabilitation, and behavioral health.

• Forge partnerships with hospital care management, post-acute providers, and other care managers to ensure smooth transitions and continuity of care.

• Engage in system and regional initiatives aimed at enhancing transitions of care and preventing unnecessary duplicative services.

• Conduct root cause analyses of prolonged post-acute stays, inappropriate utilization, and readmissions; monitor key metrics.

• Stay informed about industry, regulatory, technology, and market trends impacting ambulatory and post-acute services.

• Advocate for Intermountain Health's mission, vision, values, and standards of service behavior.

⛳️ Requirements

• Current Registered Nurse (RN) license in the state where practice occurs.

• Bachelor of Science in Nursing (BSN) from an accredited institution; degree verification is mandatory.

• RNs hired or promoted into this position must achieve their BSN within four years of their hire or promotion.

• Proven clinical nursing experience in chronic disease management.

• Understanding of chronic disease terminology and processes.

• Demonstrated comprehension of disease management, including treatment protocols, length of stay, barriers to care delivery, and variations.

• Basic computer skills with knowledge of Microsoft Office software.

• Care Management Certification is preferred.

• Experience in ambulatory transitional care or telephonic triage is preferred.

• Intermediate computer skills and knowledge of Microsoft Office software are preferred.

• Must reside in Colorado or Montana and be located within close proximity to an Intermountain Health facility, ideally within an hour's commute.

• Capability to work specified alternating shifts and scheduled weekly hours.

• Ability to perform necessary visual, auditory, manual dexterity, computer, communication, and potential driving tasks.

🏝️ Benefits

• Comprehensive benefits package that includes wellness, health, security, connection, and engagement programs.

• PEAK program offering upfront tuition coverage paid directly to the educational institution.

• Over 100 learning options, encompassing undergraduate studies, high school diplomas, and professional skills and certificates.

• PEAK eligibility starts on the first day of employment.

• Remote work expectations entail the use of company equipment.