RN Clinical Consultation

Company: Sedgwick Claims Management Services, Inc
Location: Nashville
Posted on: January 13, 2021

Job Description:

RN Clinical ConsultationIF YOU CARE, THERE'S A PLACE FOR YOU HEREFor a career path that is both challenging and rewarding, join Sedgwick's talented team of 21,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets -- their employees, their customers and their property. At Sedgwick, caring counts--. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.For nearly 50 years, Sedgwick has been helping employers answer virtually every question there is about workers' compensation. We have experience in nearly every type of industry, in every region, providing the broadest range of programs and services.PRIMARY PURPOSE:--To triage calls from clients; to assess needs, giving appropriate care advice and disposition to appropriate level of care treatment facility; to promote quality cost-effective outcomes through communication and available resources; and to provide quality, cost effective alternatives to emergency or acute care.ESSENTIAL FUNCTIONS and RESPONSIBILITIES* Applies all phases of the nursing process; i.e. assessment, planning, implementation and evaluation when triaging calls.* Identifies the needs of caller by triaging, obtaining general health information and/or physician services referral.* Evaluates need for alternative treatment through telephonic contact and assessment with service provider.* Triages patient utilizing computerized protocols/algorithms; interviews patient to obtain pertinent data; and enters data into computer system.* Identifies life-threatening emergencies and recommends appropriate interventions.* Refers issues requiring physician interventions to physician in a timely manner; directs patients to appropriate level of care including but not limited to the nearest emergency room, urgent care facility, primary treating physician or home care.* Demonstrates effective verbal communications; communicates phone advice in a calm manner ensuring it is properly received and understood.* Adheres to quality assurance standards.* Interacts and coordinates work of Physician Advisors as necessary.* Serves as resource to triage team members.ADDITIONAL FUNCTIONS and RESPONSIBILITIES* Performs other duties as assigned.* Supports the organization's quality program(s).QUALIFICATIONSEducation & LicensingBachelor's--degree in nursing preferred.--Active unrestricted RN license issued in United States required.ExperienceFive (5) years of related experience or equivalent combination of education and experience required to include three (3) years recent clinical practice experience.Skills & Knowledge* Strong knowledge of nursing practice and theory* Knowledge of the insurance industry and claims processing* Knowledge of current alternative resources and treatments in out-patient and alternative care settings* Excellent oral and written communication, including presentation skills* PC literate, including Microsoft Office products* Analytical and interpretive skills* Strong organizational skills* Excellent interpersonal skills* Excellent negotiation skills* Ability to work in a team environment* Ability to meet or exceed Performance CompetenciesWORK ENVIRONMENTWhen applicable and appropriate, consideration will be given to reasonable accommodations.Mental:--Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlinesPhysical:--Computer keyboarding, travel as requiredAuditory/Visual:--Hearing, vision and talkingThe statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description.--They are not intended to constitute a comprehensive list of functions, duties, or local variances.--Management retains the discretion to add or to change the duties of the position at any time.Sedgwick--is an Equal Opportunity Employerand aDrug-Free Workplace

Keywords: Sedgwick Claims Management Services, Inc, Nashville , RN Clinical Consultation, Other , Nashville, Tennessee