Triage RN - Virtual - CareBridge

Virtual Work

This role enables associates to work virtually full-time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development.

This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

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, NJ, HI or VA.

The Triage Nurse I - Care Bridge 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.

• Requires AS in nursing and minimum of 2 years of acute care clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current unrestricted RN license in the applicable state(s) required.

• Current, active, RN Compact license highly preferred.
• Emergency Room and/or Urgent Care experience highly preferred.
• Telehealth experience.
• Experience with EMR systems.
• BS in nursing preferred.
• Participation and/or certification in a managed care or utilization management organization preferred.
• Ability to understand clinical information and prepare a concise summary following department standards strongly preferred.
• Basic knowledge of the medical management and care management process and role preferred.

For candidates working in person or virtually in the below location(s), the salary range for this specific position is $65,600 to $113,160. Locations:
Cleveland, OH;
Columbus, OH;
Massachusetts;
New Jersey, Hawaii.

In addition to your salary, Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution. The salary offered for this specific position is based on a number of legitimate, non‑discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, and local laws.

Applicants who require accommodation to participate in the job application process may contact elevancehealthj for assistance.