telephonic nurse case manager

DAVIES

<div><h3 class="jobSectionHeader">Description</h3><div> 
Our Story</div><div>
Imagine being part of a team that&rsquo;s not just shaping the future but actively driving it. At Davies North America, we&rsquo;re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.</div><div>
 
Davies North America is seeking a Triage Telephonic Case Manager (RN) to join our medical management team. In this role, you will provide clinical triage and telephonic case management at the initial report of a Workers&rsquo; Compensation claim, ensuring injured employees receive appropriate and timely medical care while supporting early return-to-work outcomes. 
</div><div>This position requires strong clinical assessment skills, independent decision-making, and excellent communication to coordinate care between injured workers, employers, healthcare providers, and claims professionals.</div> 
<h3 class="jobSectionHeader">
Key Responsibilities</h3> 
<ul>
<li>
Conduct initial triage and telephonic case management at the outset of Workers&rsquo; Compensation claims.</li>
<li>Perform clinical assessments of injured workers to determine appropriate medical care and treatment pathways.</li>
<li>Complete initial assessment and required three-point contact in accordance with State of Florida procedures and emergency protocols.</li>
<li>Develop an initial case management care plan based on clinical findings and information obtained from the injured worker, employer, and medical provider.</li>
<li>Identify potential causation concerns or barriers to recovery and document findings appropriately.</li>
<li>Facilitate communication between injured workers, employers, claims professionals, healthcare providers, and rehabilitation specialists.</li>
<li>Monitor treatment plans to ensure adherence to state-mandated treatment guidelines and evidence-based medical protocols.</li>
<li>Address initial return-to-work capabilities with injured workers and providers, documenting updates in the case management system.</li>
<li>Maintain accurate and timely documentation of all contacts, interviews, and medical information in the claims management system.</li>
<li>Identify opportunities for cost-effective medical management and appropriate utilization of services.</li>
<li>Educate injured workers and their families about recovery expectations and care plans.</li>
<li>Maintain strict patient confidentiality and compliance with state and federal healthcare regulations.</li>
<li>Serve as a patient advocate, ensuring quality care and adherence to ethical and regulatory standards.</li>
<li>Participate in quality assurance initiatives, committees, and department activities as required.</li>
<li>Assist with training claims staff on identifying medical case management opportunities, as needed.</li></ul> 
<h3 class="jobSectionHeader">
Skills, knowledge &amp; expertise</h3> 
<ul>
<li>
Registered Nurse (RN) with an active and unrestricted state license</li>
<li>Minimum of 3 years of clinical nursing experience (medical-surgical, orthopedic, neurological, ICU/CCU, occupational health, or related specialty).</li>
<li>Workers&rsquo; Compensation case management experience preferred.</li>
<li>Prior telephonic case management or triage experience preferred.</li>
<li>Strong understanding of clinical documentation and patient advocacy principles.</li>
<li>Strong clinical assessment and triage skills in a Workers&rsquo; Compensation or occupational health environment.</li>
<li>Knowledge of Workers&rsquo; Compensation medical case management practices and treatment guidelines.</li>
<li>Ability to identify barriers to recovery and develop appropriate care strategies.</li>
<li>Excellent verbal and written communication skills, with the ability to work collaboratively with multiple stakeholders.</li>
<li>Strong organizational and documentation skills with attention to detail.</li>
<li>Ability to work independently and manage multiple priorities in a fast-paced environment.</li>
<li>Proficiency with computer systems, case management software, and Microsoft Office applications.</li>
<li>Commitment to high-quality patient care, confidentiality, and regulatory compliance.</li></ul> 
<h3 class="jobSectionHeader">
Benefits</h3><div> 
Benefits</div><div>
At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:</div><ul>
<li>Medical, dental, and vision plans to ensure your health and that of your family.</li>
<li>A 401k plan with employer matching to help you build a secure financial future.</li>
<li>Our time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.</li>
<li>Paid holidays.</li>
<li>Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.</li>
</ul><div></div><div>
Massachusetts Notice 
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. 
</div><div>Diversity and Inclusion</div><div>
Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard. 
 
Compensation Transparency:
 
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.
 
 
We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at recruitment@davies-group.com</div> 
<h3 class="jobSectionHeader">
About Davies</h3><div>
We are a specialist professional services and technology firm, working in partnership with leading insurance, highly regulated and global businesses. 
 
We help our clients to manage risk, operate their core business processes, transform and grow. We deliver professional services and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation &amp; risk, customer experience, human capital, digital transformation &amp; change management. 
 
Our global team of more than 8,000 professionals operate across ten countries, including the UK &amp; the U.S. Over the past ten years Davies has grown its annual revenues more than 20-fold, investing heavily in research &amp; development, innovation &amp; automation, colleague development, and client service. Today the group serves more than 1,500 insurance, financial services, public sector, and other highly regulated clients.</div></div>

Triage Telephonic Nurse Case Manager

TriHealth Inc.

<div>Join Our Team as a Practice Telephonic Triage Registered Nurse! 
At TriHealth, we are driven by a shared commitment to excellence and innovation in healthcare. We believe that every test, analysis, and result plays a vital role in our mission to provide the highest standard of care to our patients. 
Join us in our mission to advance healthcare and improve lives. Apply today and be part of a team that is passionate about making a difference. 
We offer career growth opportunities, and a comprehensive benefits package. 
Location:<ul><li>
TriHealth Peds &ndash; at 740 W Galbraith Rd</li></ul> 
Work Schedule:<ul><li>
Part - Time (50 hours bi-weekly)</li><li>
Rotating Weekends, no holidays or on call</li><li>
Day shift</li></ul> 
Incentives &amp; Benefits:
We offer a comprehensive benefits package, including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement.
https://careers.trihealth.com/what-we-offer/benefits 
Job Requirements:<ul><li>
Associate's Degree in Nursing (Required)</li><li>
2 - 3 years Clinical Nursing (Required)</li><li>
Acute Care</li><li>
Strong Computer Skills</li><li>
Ability to type and talk at the same time</li><li>
Knowledge, judgment, and skills derived from the principles of Biological, 
Physical, Behavioral, Social, and Nursing sciences.</li><li>
Registered Nurse RN - Registered Nurse - State Licensure and/or Compact State Licensure Upon Hire Required</li><li>
Basic Life Support (BLS) Upon Hire Required</li></ul> 
Job Overview:<ul><li>
The Telephonic Triage RN is responsible for providing nursing care services to assigned practice(s)/specialty(s). Completes bio-psychosocial telephonic assessment using approved clinical protocols to triage patient needs and provide best course of action or patient disposition. This role serves as a patient/caregiver advocate and acts as a communication link between the patient/caregiver, physician, pharmacy, and or hospital using approved system platforms for communication. This role has a strong working knowledge of patient needs that are emergent and require immediate attention, urgent, and non-urgent. This role utilizes best practices in documentation to ensure communication is efficient, concise, and timely. The goal is to provide first call resolution. This role understand the needs of the organization and supports the mission, values, and management of TriHealth Physician Practices.</li></ul> 
Job Responsibilities:<ul><li>
Coaching/Development: Promotes a positive work environment by working collaboratively with team members, recognizing colleagues for excellence, and participating in peer to peer coaching</li> 
<li>
Interdisciplinary Collaboration: Manages In-Basket messages received in a timely manner. Responds to and addresses patient concerns, first call resolution, when in scope. When applicable, ensures all messages sent to providers have complete and accurate information. Implements changes in nursing practice/patient care that have resulted from quality of care activities.</li></ul> 
<ul><li>
Operations Management: Operating in &quot;Ready&quot; mode during work hours with minimum utilization of &quot;AUX/Not Ready&quot;. Goal is &lt;20% of total time staffed. Completes patient hand-offs to healthcare team/providers concisely and accurately using SBAR. Completes assigned work requirements utilizing critical thinking and clinical protocols during assessment and triage of patient call/message.</li></ul> 
<ul><li>
Patient Engagement: Utilizes key tools such as AIDET+P, HEARD Model, scripting, and workflows to create a standard patient experience across the system. Proactively handles complaints and escalates patient grievances to practice or appropriate leader.</li><li>
Quality/Safety/Satisfaction: Assesses and triages patient status via phone and EHR. Utilizes approved clinical protocols to support patient disposition or clinical advice. Reviews health maintenance and or specialists documentation/flowsheet. Provides education materials per guidelines.</li></ul> 
<ul><li>
Relationship/Culture: Performs activities that maintains specialty/department specific models of care, systems, policies, approved clinical protocols, and cultural norms that deliver superior patient care. Participates and supports collaborative relationships among the healthcare team and providers. Supports diversity and utilizes cultural competency and age appropriate care when interacting with patients and caregivers.</li></ul> 
Working Conditions: 
Bending - Occasionally 
Climbing - Occasionally 
Concentrating - Consistently 
Continuous Learning - Consistently 
Hearing: Conversation - Consistently 
Hearing: Other Sounds - Consistently 
Interpersonal Communication - Consistently 
Kneeling - Occasionally 
Lifting &lt;10 Lbs. - Occasionally 
Lifting &lt;50 Lbs. - Rarely 
Pulling - Occasionally 
Pushing - Occasionally 
Reaching - Consistently 
Reading - Consistently 
Sitting - Frequently 
Standing - Occasionally 
Stooping - Occasionally 
Talking - Consistently 
Thinking/Reasoning - Consistently 
Use of Hands - Consistently 
Color Vision - Frequently 
Visual Acuity: Far - Rarely 
Visual Acuity: Near - Consistently 
Walking - Occasionally<div> 
TriHealth SERVE Standards and ALWAYS Behaviors: 
At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: 
 
Serve: ALWAYS&hellip; 
<ul><li>Welcome everyone by making eye contact, greeting with a smile, and saying &quot;hello&quot;</li><li>Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist</li><li>Refrain from using cell phones for personal reasons in public spaces or patient care areas</li></ul></div><div> 
Excel: ALWAYS&hellip; 
<ul><li>Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met</li><li>Offer patients and guests priority when waiting (lines, elevators)</li><li>Work on improving quality, safety, and service</li></ul></div><div> 
Respect: ALWAYS&hellip; 
<ul><li>Respect cultural and spiritual differences and honor individual preferences.</li><li>Respect everyone&rsquo;s opinion and contribution, regardless of title/role.</li><li>Speak positively about my team members and other departments in front of patients and guests.</li></ul></div><div> 
Value: ALWAYS&hellip; 
<ul><li>Value the time of others by striving to be on time, prepared and actively participating.</li><li>Pick up trash, ensuring the physical environment is clean and safe.</li><li>Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.</li></ul></div><div> 
Engage: ALWAYS&hellip; 
<ul><li>Acknowledge wins and frequently thank team members and others for contributions.</li><li>Show courtesy and compassion with customers, team members and the community</li></ul></div>
Job Keywords: Registered Nurse, Nurse, Practice Telephonic Triage, Pediatrics</div>

Practice Telephonic Triage RN - Peds

CVS Health

<div>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.
This RN Case Manager position is 100% remote and candidates can apply from any state.
Normal Working Hours: Monday through Friday between the hours of 8:00am &ndash; 7:00pm CSTfor a scheduled 8-hour shift. Preference is for an RN with Compact RN licensure who lives in either CST, MST, or PST time zone.
Weekends may be required per the needs of the department.
This position is with Aetna's Commercial Care Management division on the dedicated team supporting Amazon's membership.
Employees will have an occasional evening shift rotation per the needs of the team.
Less than 10% travel may be required for on-site meetings, trainings, or system updates, or to meet licensure requirements e.g., finger printing.
The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate overall wellness.
RN Case Manager:
&ndash; Collaboratively develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member&rsquo;s overall wellness through integration.
&ndash; Through the use of clinical tools and information/data review (e.g., assessments, claims, etc..) conducts an evaluation of member&rsquo;s needs and available benefits to collaborate and refer to programs offered by the plan sponsor.
&ndash; Applies clinical judgment to reduce risk factors, address complex health issues and social indicators.
&ndash; Utilizes case management processes in compliance with regulatory and company policies and procedures.
&ndash; Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. 
Required Qualifications:<ul><li>Must have an active and unrestricted RN license and, if located within the Nurse Licensure Compact jurisdiction, the ability to use their compact license without restriction</li><li>Willingness and ability to obtain additional state licenses upon hire (paid for by the company)</li><li>3+ years of acute care clinical experience as an RN (general medical, post-surgical, specialty including pediatrics, ICU, case management and discharge planning)</li><li>Ability to use a computer station with multiple screens, operate multiple programs simultaneously, and sit for extended periods of time</li><li>A private designated workspace free of distractions and high-speed internet</li></ul> 
Preferred Qualifications:<ul><li>Compact RN licensure</li><li>RN living in CST, MST, or PST Time Zone</li><li>1+ years of case management experience</li><li>Certified Case Manager (CCM) certification</li><li>Strong customer service skills including attention to customers, sensitivity to certain issues and proactive identification/resolution of issues.</li><li>Experience with all types of Microsoft Office including PowerPoint, Excel, and Word</li><li>Strong telephonic communication skills</li><li>1+ years of experience utilizing computers and navigating multiple monitors while speaking with someone on the telephone.</li><li>BSN</li><li>Transgender certification</li></ul> 
Education:<ul><li>Associates in nursing</li></ul>
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$60,522.00 - $129,615.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul><li>
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li><li>
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li><li>
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li></ul>
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 04/04/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</div>

Registered Nurse Care Manager

Fresenius Medical Care

<div></div><div><div>PURPOSE AND SCOPE:
Manages a team that promotes quality patient care, ongoing patient support and case management for Fresenius Medical Care (FMCNA) renal patient population (internal and external) through staff with the provision of guidance, subject matter expertise, training and support to assigned telephonic staff. Collaborates with clinical staff to assist the patient in making informed decisions, regarding dialysis and insurance issues.
PRINCIPAL DUTIES AND RESPONSIBILITIES:<ul><li>
Provides oversight to the daily operations of assigned team, including but not limited to, establishing mutual goals, maintaining schedules, checking work at frequent intervals and assigning tasks and duties to improve and promote teamwork for overall department and individual growth.</li><li>
Provides subject matter expertise, leadership, support and guidance to assigned staff regarding procedures, issues and problems, ensuring appropriate application and resolution.
</li><li>Leverages team to identify, analyze, plan, organize and develop new workflow processes and/or modifies existing processes as appropriate to meet the program requirements, improve quality of care, reduce health care costs, and enhance / support the patient&rsquo;s health care or insurance needs.
</li><li>Provides strategic guidance with development of outcome and productivity reports and prepares other pertinent statistical reports noting trends and issues.
</li><li>Acts as a liaison for clinical stakeholders to address and resolve patient concerns or issues.
</li><li>Oversees caseload assignments based on patient /clinic volume and licensure requirements. Ensures team meetings compliance with state RN licenses to meet business needs.
</li><li>Utilizes evidenced based and best demonstrated practices to address barriers to quality improvement. This includes promoting the adoption and utilization of Corporate Medical Advisory Board Recommended Algorithms and Standing Orders, clinical pathways and clinical policies and procedures to improve care coordination and delivery.</li><li>
Responsible for offering staff education and development opportunities in partnership with the case management leadership, facilitates meetings and hosts staff meetings.</li><li>
Creates and provides presentations to clinical and case management staff, as appropriate.</li><li>
May be assigned a patient load depending on volume and need.
</li><li>Performs other related duties as assigned.</li></ul>
PHYSICAL DEMANDS AND WORKING CONDITIONS:<ul><li>
The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.<ul><li>
This job operates in an office setting. While performing the duties of this job, the employee is regularly required to talk and hear. This role routinely and frequently uses a desk and standard office equipment such as computers, phones, and photocopiers with repetitive motion.</li><li>
This position requires approximately 0% to 10% travel.</li></ul></li></ul>
SUPERVISION:<ul><li>
Responsible for the direct supervision of various levels of telephonic staff.</li></ul>
EDUCATION AND REQUIRED CREDENTIALS:<ul><li>
Bachelor&rsquo;s Degree; Advanced Degree desirable or an equivalent combination of education and experience</li><li>
BSN required with active unrestricted nursing licensure in practicing state &ndash; with the ability to obtain licensure in multiple states.</li><li>
Certified Case Manager (CCM) required.</li><li>
Certification in nephrology specialty (CNN, CDN) a plus.</li></ul>
EXPERIENCE AND SKILLS:
<ul><li>8 &ndash; 10 years&rsquo; related experience or an equivalent combination of education and experience.</li><li>
3+ years&rsquo; experience as a Manager preferred.</li><li>
Demonstrated ability to manage one or more departments.
</li><li>Must exhibit management/leadership skills and be able to work with and influence staff in the clinics.</li><li>
Must have knowledge of teaching-learning process, principles, and methods of adult education.</li><li>
Must be self-motivated and able to plan a diversity of activities and work independently.</li><li>
Ability to function as a part of an integrated team.
</li><li>Ability to follow oral and written communication and communicate information to individuals or groups with varying levels of education.</li><li>
Excellent communication, verbal and written, and customer service skills.
</li><li>Organized and detail oriented.</li><li>
Must exhibit practical computer skills such as e-mail, Word documents, and basic Excel spreadsheet skills. PowerPoint skills are preferred. Must be able to type proficiently.</li></ul>
The rate of pay for this position will depend on the successful candidate&rsquo;s work location and qualifications, including relevant education, work experience, skills, and competencies. 
 
Rate: $XX - $XX 
 
Non-Bonus Eligible Positions: include language below. 
 
Benefit Overview: This position offers a comprehensive benefits package including medical, dental, and vision insurance, a 401(k) with company match, paid time off, parental leave. 
 
Bonus Eligible Positions &ndash; include language below. 
 
Benefit Overview: This position offers a comprehensive benefits package including medical, dental, and vision insurance, a 401(k) with company match, paid time off, parental leave and potential for performance-based bonuses depending on company and individual performance
Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.</div>
EOE, disability/veterans</div>

Sr Manager Telephonic Case Management

<div>Join Our Team as a Practice Telephonic Triage Registered Nurse! 
At TriHealth, we are driven by a shared commitment to excellence and innovation in healthcare. We believe that every test, analysis, and result plays a vital role in our mission to provide the highest standard of care to our patients. 
Join us in our mission to advance healthcare and improve lives. Apply today and be part of a team that is passionate about making a difference. 
We offer career growth opportunities, and a comprehensive benefits package. 
Location:<ul><li>
TriHealth Family Medicine &ndash; at 7631 Cheviot Rd, Cincinnati, OH 45247</li></ul> 
Work Schedule:<ul><li>
Full - Time (80 hours bi-weekly)</li><li>
Day shift</li></ul> 
Incentives &amp; Benefits:
We offer a comprehensive benefits package, including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement.
https://careers.trihealth.com/what-we-offer/benefits 
Job Requirements:<ul><li>
Associate's Degree in Nursing (Required)</li><li>
2 - 3 years Clinical Nursing (Required)</li><li>
Acute Care</li><li>
Strong Computer Skills</li><li>
Ability to type and talk at the same time</li><li>
Knowledge, judgment, and skills derived from the principles of Biological, 
Physical, Behavioral, Social, and Nursing sciences.</li><li>
Registered Nurse RN - Registered Nurse - State Licensure and/or Compact State Licensure Upon Hire Required</li><li>
Basic Life Support (BLS) Upon Hire Required</li></ul> 
Job Overview:<ul><li>
The Telephonic Triage RN is responsible for providing nursing care services to assigned practice(s)/specialty(s). Completes bio-psychosocial telephonic assessment using approved clinical protocols to triage patient needs and provide best course of action or patient disposition. This role serves as a patient/caregiver advocate and acts as a communication link between the patient/caregiver, physician, pharmacy, and or hospital using approved system platforms for communication. This role has a strong working knowledge of patient needs that are emergent and require immediate attention, urgent, and non-urgent. This role utilizes best practices in documentation to ensure communication is efficient, concise, and timely. The goal is to provide first call resolution. This role understand the needs of the organization and supports the mission, values, and management of TriHealth Physician Practices.</li></ul> 
Job Responsibilities:<ul><li>
Coaching/Development: Promotes a positive work environment by working collaboratively with team members, recognizing colleagues for excellence, and participating in peer to peer coaching</li> 
<li>
Interdisciplinary Collaboration: Manages In-Basket messages received in a timely manner. Responds to and addresses patient concerns, first call resolution, when in scope. When applicable, ensures all messages sent to providers have complete and accurate information. Implements changes in nursing practice/patient care that have resulted from quality of care activities.</li></ul> 
<ul><li>
Operations Management: Operating in &quot;Ready&quot; mode during work hours with minimum utilization of &quot;AUX/Not Ready&quot;. Goal is &lt;20% of total time staffed. Completes patient hand-offs to healthcare team/providers concisely and accurately using SBAR. Completes assigned work requirements utilizing critical thinking and clinical protocols during assessment and triage of patient call/message.</li></ul> 
<ul><li>
Patient Engagement: Utilizes key tools such as AIDET+P, HEARD Model, scripting, and workflows to create a standard patient experience across the system. Proactively handles complaints and escalates patient grievances to practice or appropriate leader.</li><li>
Quality/Safety/Satisfaction: Assesses and triages patient status via phone and EHR. Utilizes approved clinical protocols to support patient disposition or clinical advice. Reviews health maintenance and or specialists documentation/flowsheet. Provides education materials per guidelines.</li></ul> 
<ul><li>
Relationship/Culture: Performs activities that maintains specialty/department specific models of care, systems, policies, approved clinical protocols, and cultural norms that deliver superior patient care. Participates and supports collaborative relationships among the healthcare team and providers. Supports diversity and utilizes cultural competency and age appropriate care when interacting with patients and caregivers.</li></ul> 
Working Conditions: 
Bending - Occasionally 
Climbing - Occasionally 
Concentrating - Consistently 
Continuous Learning - Consistently 
Hearing: Conversation - Consistently 
Hearing: Other Sounds - Consistently 
Interpersonal Communication - Consistently 
Kneeling - Occasionally 
Lifting &lt;10 Lbs. - Occasionally 
Lifting &lt;50 Lbs. - Rarely 
Pulling - Occasionally 
Pushing - Occasionally 
Reaching - Consistently 
Reading - Consistently 
Sitting - Frequently 
Standing - Occasionally 
Stooping - Occasionally 
Talking - Consistently 
Thinking/Reasoning - Consistently 
Use of Hands - Consistently 
Color Vision - Frequently 
Visual Acuity: Far - Rarely 
Visual Acuity: Near - Consistently 
Walking - Occasionally<div> 
TriHealth SERVE Standards and ALWAYS Behaviors: 
At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: 
 
Serve: ALWAYS&hellip; 
<ul><li>Welcome everyone by making eye contact, greeting with a smile, and saying &quot;hello&quot;</li><li>Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist</li><li>Refrain from using cell phones for personal reasons in public spaces or patient care areas</li></ul></div><div> 
Excel: ALWAYS&hellip; 
<ul><li>Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met</li><li>Offer patients and guests priority when waiting (lines, elevators)</li><li>Work on improving quality, safety, and service</li></ul></div><div> 
Respect: ALWAYS&hellip; 
<ul><li>Respect cultural and spiritual differences and honor individual preferences.</li><li>Respect everyone&rsquo;s opinion and contribution, regardless of title/role.</li><li>Speak positively about my team members and other departments in front of patients and guests.</li></ul></div><div> 
Value: ALWAYS&hellip; 
<ul><li>Value the time of others by striving to be on time, prepared and actively participating.</li><li>Pick up trash, ensuring the physical environment is clean and safe.</li><li>Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.</li></ul></div><div> 
Engage: ALWAYS&hellip; 
<ul><li>Acknowledge wins and frequently thank team members and others for contributions.</li><li>Show courtesy and compassion with customers, team members and the community</li></ul></div>
Job Keywords: Registered Nurse, Nurse, Practice Telephonic Triage, Family Medicine</div>

Practice Telephonic Triage RN - Family Medicine

<div>Join Our Team as a Practice Telephonic Triage Registered Nurse! 
At TriHealth, we are driven by a shared commitment to excellence and innovation in healthcare. We believe that every test, analysis, and result plays a vital role in our mission to provide the highest standard of care to our patients. 
Join us in our mission to advance healthcare and improve lives. Apply today and be part of a team that is passionate about making a difference. 
We offer career growth opportunities, and a comprehensive benefits package. 
Location:<ul><li>
TriHealth Glenway Peds &ndash; at 6350 Glenway Ave, Cincinnati, OH 45211</li></ul> 
Work Schedule:<ul><li>
Full - Time (72 hours bi-weekly)</li><li>
Day Shift &ndash; Mon 7:45am-5:15pm, Tues 12:00pm-7:00pm, Wed OFF, Thurs 7:45am-5:15pm, &amp; Fri 7:45am-5:30pm.</li><li>
There is a weekend rotation. Saturday (every 3-4 weekend, 8am-1pm) and Sunday (every eighth or nineth 9am-12:30/1pm).</li></ul> 
Incentives &amp; Benefits:
We offer a comprehensive benefits package, including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement.
https://careers.trihealth.com/what-we-offer/benefits 
Job Requirements:<ul><li>
Associate's Degree in Nursing (Required)</li><li>
2 - 3 years Clinical Nursing (Required)</li><li>
Acute Care</li><li>
Strong Computer Skills</li><li>
Ability to type and talk at the same time</li><li>
Knowledge, judgment, and skills derived from the principles of Biological, 
Physical, Behavioral, Social, and Nursing sciences.</li><li>
Registered Nurse RN - Registered Nurse - State Licensure and/or Compact State Licensure Upon Hire Required</li><li>
Basic Life Support (BLS) Upon Hire Required</li></ul> 
Job Overview:<ul><li>
The Telephonic Triage RN is responsible for providing nursing care services to assigned practice(s)/specialty(s). Completes bio-psychosocial telephonic assessment using approved clinical protocols to triage patient needs and provide best course of action or patient disposition. This role serves as a patient/caregiver advocate and acts as a communication link between the patient/caregiver, physician, pharmacy, and or hospital using approved system platforms for communication. This role has a strong working knowledge of patient needs that are emergent and require immediate attention, urgent, and non-urgent. This role utilizes best practices in documentation to ensure communication is efficient, concise, and timely. The goal is to provide first call resolution. This role understand the needs of the organization and supports the mission, values, and management of TriHealth Physician Practices.</li></ul> 
Job Responsibilities:<ul><li>
Coaching/Development: Promotes a positive work environment by working collaboratively with team members, recognizing colleagues for excellence, and participating in peer to peer coaching.</li> 
<li>
Interdisciplinary Collaboration: Manages In-Basket messages received in a timely manner. Responds to and addresses patient concerns, first call resolution, when in scope. When applicable, ensures all messages sent to providers have complete and accurate information. Implements changes in nursing practice/patient care that have resulted from quality of care activities.</li></ul> 
<ul><li>
Operations Management: Operating in &quot;Ready&quot; mode during work hours with minimum utilization of &quot;AUX/Not Ready&quot;. Goal is &lt;20% of total time staffed. Completes patient hand-offs to healthcare team/providers concisely and accurately using SBAR. Completes assigned work requirements utilizing critical thinking and clinical protocols during assessment and triage of patient call/message.</li></ul> 
<ul><li>
Patient Engagement: Utilizes key tools such as AIDET+P, HEARD Model, scripting, and workflows to create a standard patient experience across the system. Proactively handles complaints and escalates patient grievances to practice or appropriate leader. 
Quality/Safety/Satisfaction: Assesses and triages patient status via phone and EHR. Utilizes approved clinical protocols to support patient disposition or clinical advice. Reviews health maintenance and or specialists documentation/flowsheet. Provides education materials per guidelines.</li></ul> 
<ul><li>
Relationship/Culture: Performs activities that maintains specialty/department specific models of care, systems, policies, approved clinical protocols, and cultural norms that deliver superior patient care. Participates and supports collaborative relationships among the healthcare team and providers. Supports diversity and utilizes cultural competency and age appropriate care when interacting with patients and caregivers.</li></ul> 
Working Conditions: 
Bending - Occasionally 
Climbing - Occasionally 
Concentrating - Consistently 
Continuous Learning - Consistently 
Hearing: Conversation - Consistently 
Hearing: Other Sounds - Consistently 
Interpersonal Communication - Consistently 
Kneeling - Occasionally 
Lifting &lt;10 Lbs. - Occasionally 
Lifting &lt;50 Lbs. - Rarely 
Pulling - Occasionally 
Pushing - Occasionally 
Reaching - Consistently 
Reading - Consistently 
Sitting - Frequently 
Standing - Occasionally 
Stooping - Occasionally 
Talking - Consistently 
Thinking/Reasoning - Consistently 
Use of Hands - Consistently 
Color Vision - Frequently 
Visual Acuity: Far - Rarely 
Visual Acuity: Near - Consistently 
Walking - Occasionally<div> 
TriHealth SERVE Standards and ALWAYS Behaviors: 
At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: 
 
Serve: ALWAYS&hellip; 
<ul><li>Welcome everyone by making eye contact, greeting with a smile, and saying &quot;hello&quot;</li><li>Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist</li><li>Refrain from using cell phones for personal reasons in public spaces or patient care areas</li></ul></div><div> 
Excel: ALWAYS&hellip; 
<ul><li>Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met</li><li>Offer patients and guests priority when waiting (lines, elevators)</li><li>Work on improving quality, safety, and service</li></ul></div><div> 
Respect: ALWAYS&hellip; 
<ul><li>Respect cultural and spiritual differences and honor individual preferences.</li><li>Respect everyone&rsquo;s opinion and contribution, regardless of title/role.</li><li>Speak positively about my team members and other departments in front of patients and guests.</li></ul></div><div> 
Value: ALWAYS&hellip; 
<ul><li>Value the time of others by striving to be on time, prepared and actively participating.</li><li>Pick up trash, ensuring the physical environment is clean and safe.</li><li>Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.</li></ul></div><div> 
Engage: ALWAYS&hellip; 
<ul><li>Acknowledge wins and frequently thank team members and others for contributions.</li><li>Show courtesy and compassion with customers, team members and the community</li></ul></div>
Job Keywords: Registered Nurse, Nurse, Pediatrics</div>

<div>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.
Position Summary:
This RN Case Manager position is 100% remote and candidates are required to live PST or MST. Preference is for an RN with Compact RN licensure.
Normal Working Hours: Monday through Friday 8am-5pm in time zone of residence with requirement to flex time to meet member/business needs.
The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate overall wellness.
RN Case Manager:
&ndash; Collaboratively develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member&rsquo;s overall wellness through integration.
&ndash; Through the use of clinical tools and information/data review (e.g., assessments, claims, etc..) conducts an evaluation of member&rsquo;s needs and available benefits to collaborate and refer to programs offered by the plan sponsor.
&ndash; Applies clinical judgment to reduce risk factors, address complex health issues and social indicators.
&ndash; Utilizes case management processes in compliance with regulatory and company policies and procedures.
&ndash; Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.
Please note:<ul><li>This role involves using a computer station with multiple screens, operating multiple programs simultaneously, and sitting for extended periods of time.</li><li>A private designated workspace free of distractions and high-speed internet is needed for this position.</li></ul>
Required Qualifications:<ul><li>Must have an active and unrestricted RN license in state of residence, preferably compact</li><li>RN living in MST, or PST Time Zone</li><li>Willingness and ability to obtain additional state licenses upon hire (paid for by the company)</li><li>3+ years of acute care clinical experience as an RN (general medical, post-surgical, specialty including pediatrics, ICU, case management and discharge planning)</li></ul>
Preferred Qualifications:<ul><li>Compact RN licensure</li><li>1+ years of case management experience</li><li>Certified Case Manager (CCM) certification</li><li>Strong customer service skills including attention to customers, sensitivity to certain issues and proactive identification/resolution of issues.</li><li>Experience with all types of Microsoft Office including PowerPoint, Excel, and Word</li><li>Strong telephonic communication skills</li><li>1+ years of experience utilizing computers and navigating multiple monitors while speaking with someone on the telephone.</li><li>Transgender certification</li></ul>
Education:<ul><li>Associates in nursing</li><li>BSN</li></ul>
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$66,575.00 - $142,576.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul><li>
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li><li>
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li><li>
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li></ul>
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 03/28/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</div>

Case Manager RN - Work From Home - MST or PST

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