Registered Nurse - Iha

Clinical Resource Nurse

Position Title: Clinical Resource Nurse

Reports To: Executive Director-IHA or Designated Representative

Job Status: Full-time; Monday-Friday 8a-5p, Remote

FLSA Status: Exempt

Position Summary: Reporting to the Executive Director- IHA, the Clinical Resource Nurse will work with a multidisciplinary team including Directors, NPs, PAs, clinical support staff, and as well as other departmental staff members. The Clinical Resource Nurse is responsible for an array of tasks including communicating identified member needs to the health plan to ensure proper follow up and treatment. Evaluation of care escalations to ensure proper follow up to the PCP is completed. Coordination and review of multiple care caps (point of care tests).

Key Responsibilities:

• Manages PAD test results
• Manages HgbA1c results
• PCP verification/updates in EMR
• Monitoring for abnormal results for all point of care tests and chart review for verification for policy adherence
• Assigns collaborative physicians to onboarding providers as requested
• Manages DRE results
• Manages BMD (bone mineral density) process to schedule and complete exams
• Manages lab results; works with CSMs to develop clinical testing monitoring processes
• Manages FIT (fecal immunochemical test) results
• Liaison with clinician questions
• Management of CP audits for all markets
• Other duties as assigned
• Chart review to identify urgent or emergent needs for immediate escalation
• Manages PCP error queue
• Perform care escalation reporting for each health plan with accuracy
• Supports referrals between IHA and CareSight

Qualifications:

• Excellent organizational skills
• Ability to work independently and prioritizes tasks
• Ability to sit for long periods
• Excellent computer skills including Word, Excel, Outlook, PowerPoint
• Knowledge of HCCs/HEDIS/STARS preferred, but not required
• Fully vaccinated against COVID-19
• Ability to work with a multidisciplinary team
• Ability to adapt to change
• Problem solving skills
• Experience with EMR
• Excellent verbal and written communication skills
• 2+ years of experience as Registered Nurse (RN)
• Ability to work in a fast-paced environment