Remote Prior Authorization Rn Jobs in Santa Rosa, CA

Anchor Health is looking for a compassionate RN Triage Nurse (Full-Time) to join a strong supportive team of professionals that provide hospice/palliative care.

Position Purpose:

Under the general supervision of the Nurse Manager, the Triage Nurse is responsible for patient triage via the nurse phone line and Call Center agents, in collaboration with Clinic Administrators, providers, and other departments. The Triage Nurse provides quality patient care in compliance with local, state, and federal regulations, as well as accreditation standards.

Principal Responsibilities:

• Responds to triage calls on the nurse phone line, assessing patient needs and providing appropriate guidance.

• Manages inquiries on the pharmacy phone line, ensuring timely and accurate responses.

• Conducts patient assessments over the phone

• Determines urgency based on a telephone assessment and the patient’s medical history in the electronic medical record (EMR).

• Utilizes clinical decision-making tools, including algorithms that replicate physician logic, to guide scheduling decisions.

• Escalates high-risk cases involving symptoms such as chest pain, abdominal pain, or severe headaches, ensuring immediate ER referral or ambulance coordination.

• Provides home care guidance to patients who do not require emergency services.

• Maintains thorough documentation of consultations and treatments in the NextGen Electronic Health Record system.

• Coordinates appointments for non-emergency patients and consults with physicians as necessary.

• Acts as a resource for patient inquiries when designated as "Ask a Nurse," addressing routine questions such as vaccination schedules.

• Serves as a clinical resource and role model for nursing staff, promoting best practices.

• Manages workload effectively, prioritizing tasks and completing them promptly.

• Assists with medical chart reviews and compiles data for audits and reports.

• Supports policy development, collaborating with the Managing Nurse to establish nursing protocols and procedures.

• Ensures clear, concise, and accurate triage documentation.

• Provides patient education, offering guidance on self-care and medical conditions.

• Communicates professionally with staff, consultants, patients, families, and the community.

• Resolves conflicts proactively, improving patient satisfaction through timely responses.

• Participates in team meetings, training sessions, and planning discussions as needed.

• Performs additional duties as assigned to support clinical operations.

Requirements:

• Licensed by the State of California as a Registered Nurse.

• Current BLS certification from the American Heart Association or the American Red Cross.

• At least one year of experience in an ambulatory care setting.

• Excellent verbal and written communication skills, including strong organizational, detail-oriented, and interpersonal skills.

• Proficiency in computer skills and word processing.

Employee Benefits:

At Anchor Health, we believe in taking care of those who take care of others. If you work 30+ hours per week, you’ll enjoy competitive pay and a robust benefits package that includes:

• Medical, Dental, Vision

• Paid time off (vacation, sick leave) 

• 401(k) 

• Short- and long-term disability plans (LTD/STD).

• Life insurance policy 

• REMOTE position