Primary Care Triage Nurse (Remote - Massachusetts License Required)

The Primary Care Triage Nurse functions as a key part of the primary care team through health maintenance and chronic disease management, care coordination, and triage within the RN scope of practice. The Primary Care Triage Nurses utilizes the practice's defined protocols and workflows to assess patient needs, decide on their disposition, dispense care advice, and escalate needs to other team members where appropriate. The Primary Care Triage Nurse acts as the patient's primary point of clinical contact in the practice, and takes all incoming calls when routed by admin. The Primary Care Triage Nurse makes outbound calls in order to do ED, hospital, facility discharge checks, follow up after an acute concern, or help the team close care gaps, manage chronic diseases, or coordinate care. The Primary Care Triage Nurse also acts as the primary liaison with Care Partnership when communicating care management needs. The Primary Care Triage Nurse may assist the APC (Advanced Practice Clinician) or physician with lab orders, referrals, and scheduling urgent care visits when needed. The Primary Care Triage Nurse reports to the Triage Nurse Supervisor and is under the general supervision of the Primary Care Manager and Clinical Director.

• Provide telephonic education to patient and family regarding chronic disease management and follow-up, preventive health maintenance.
• Coordinate and schedule urgent medical appointments.
• Completes other duties as assigned by Clinical Manager.
• Act as a part of a team for the delivery of primary care
• Assists administrative staff in identifying VNA vendors when needed.
• Assists with logistical planning for vaccination efforts or other clinical initiatives.
• Evaluates and assesses health care needs utilizing established triage protocols and documented workflows.
• Takes a primary role in coordinating gap closure activities.
• Performs telephonic follow-up of inpatient and ED care as delegated by the APC/physician.
• Assists the APC/physician with submitting lab orders and follow-up as delegated.
• Utilizes nursing judgement and/or provider order in order to refer to internal and external auxiliary resources such as CCA clinical group CHW, Rehab, Nursing and APCs, home based lab services, instEd, CGW Field Team, pharmacies, etc.
• Coordination of referrals, specialty visits, testing, social services, skilled services.
• Primary telephonic contact person for clinical and care coordination needs.
• Primary point of contact with Care Partnership in coordinating health plan activities.
• Communicate and follow up with skilled services like VNA on new/routine orders, chronic disease management.
• Attend team meetings and huddles to provide input on member care and receive action items as delegated by the APC/physician.
• Maintains timely and accurate documentation
• Escalates issues to APC/physician based on triage protocol disposition, documented workflows, or nursing judgment

Required:

Associate degree or Diploma in nursing required.

Preferred:

Bachelor's Degree in nursing preferred.

Required:

Meaningful clinical experience, including:

• Critical clinical thinking skills required.
• Excellent communication skills, i.e., listening, oral and written English skills while conversing
• Must have the ability to de-escalate situations
• • Capacity to function independently within licensed scope of practice.
  • Critical clinical thinking skills required.
  • Excellent communication skills, i.e., listening, oral and written English skills while conversing
  • Must have the ability to handle stressful emergency situations calmly and effectively
  • with patients, families, and health professionals
  • Must have the ability to de-escalate situations
  • Must have the ability to effectively work with patients with various cognitive, physical, and behavioral abilities.
  Willing to learn and utilize telehealth technologies (video, chat, etc.), when appropriate, for a variety of clinical care and care management services.
• With patients, families, and health professionals
• 3+ years' experience as Registered Nurse in a high touch clinical environment or home care, OR
• Must have the ability to handle stressful emergency situations calmly and effectively
• Capacity to function independently within licensed scope of practice.
• Must have the ability to effectively work with patients with various cognitive, physical, and behavioral abilities.
• 2+ years caring for patients/members with complex medical, behavioral health, and social needs