Case Management Triage Nurse - RN (Remote U.S.)

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra seeks a Case Management Triage Nurse - RN to join our growing team. Outreach to health plan members to assess and determine if they have intervenable needs that can be addressed through Case Management, Disease Management, Health Coaching, Care Navigation, or Care Coordination. Using independent judgment, knowledge, expertise, and excellent communication skills to assess the members’ needs and engage them in enrollment into the appropriate program to meet their needs. Working collaboratively with all healthcare team members, internally and externally. ** The hours of coverage required by the contract/client for the Case Management Triage Nurse - RN roles are: Monday-Friday, 9:00 AM – 6:00 PM Eastern OR 8:00 AM – 5:00 PM Central. The specific hours worked between those times will be determined by the selected candidate's availability along with approval from your Leader. This will be agreed upon during the interviewing process, and the selected candidate must maintain the set schedule once started. **

Utilizes predictive modeling and risk tool reports to determine the priority of outreach to members based on risk score, claims history, medications, and referral task reason(s). Opens case in electronic medical record system, creates a triage program, and begins member outreach. Using motivational interviewing, complete a screening assessment to identify intervenable needs. Review needs with a member, discuss how the program can help meet their needs, and get their consent to enroll. Assign members who consent to the applicable program; provide members with the name of their assigned case manager and generate a welcome packet. Assign a "new case" task to the applicable case manager. Provide short-term interventions for members who declined CM program enrollment but have immediate needs. Complete screening assessment outcomes and document any interventions discussed with members. Educates members about community resources/options, if needed. Maintains strict standards for client confidentiality and client-related information. Complies with all organizational, state, and federal regulations and policies on confidentiality. Prepares member documentation and coordination summaries in accordance with regulatory requirements and company policies and procedures. Pursues ongoing education, certification, and self-development to remain current with case management standards and licensure requirements. The above list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.