Triage Clinical Guide (Registered Nurse) - Care OnDemand

3 days ago

Triage Clinical Guide (Registered Nurse) - Night Shift

$95,000 - $110,000 / year

Job Description A bit about this role We want to help members navigate the healthcare system in a better and safer way. This means getting the right care at the right place, at the right time. As a Triage Clinical Guide (Registered Nurse), you’ll be responsible for providing telephonic advice and clinical triage when Devoted Health members call us for support. You'll serve as a fierce advocate, helping them achieve better health outcomes and connecting them with the necessary resources. Our ideal Triage Clinical Guide is caring, compassionate, solution-oriented, and enthusiastic about providing an outstanding member experience. You possess excellent clinical judgment, are ready to innovate, and are excited about changing the way healthcare is delivered. You will be joining a team of adaptable, scrappy, and resilient professionals who are proud to be part of the Devoted family, creating a revolution in care delivery. Schedule Details: This is a full-time, night shift role. You will work three (3) scheduled clinical shifts per week on a rotating basis, including weekends and holidays. Shifts are scheduled based on business needs and may include: 8:00 PM – 8:30 AM ET (current primary shift) or occasional 6:00 PM – 6:30 AM ET (alternate shift). The remaining 2.5 hours per shift are reserved for administrative work, training, and team meetings. Shift assignments are subject to change based on operational needs, and candidates must be flexible to work either schedule as required. Your Responsibilities & Impact: Clinical Triage: Engage with members via telephone and the patient portal to provide clinical advice, educational materials, answer questions, and direct patients to the appropriate level of care. Care Coordination: Connect members with the exact care they need, whether routing them to providers within Devoted Medical, primary care, urgent care, or emergency services. Telehealth Support: Deliver exceptional support to patients with urgent complaints across multiple geographies, leveraging video telehealth visits to keep them safely at home whenever possible. Portal Chat Monitoring: Monitor clinical chat queues and respond directly to inbound patient portal messages within established response goals. Escalate to acute clinical triage via phone for new active symptoms, create appropriate Care OnDemand support episodes, and send templated replies for non-urgent administrative or routine needs. Securely share relevant educational handouts and clinical summaries after obtaining patient consent. Interdisciplinary Collaboration: Work seamlessly alongside a multidisciplinary team—including other RNs, NPs, PAs, MDs, and medical assistants—safeguarding our collaborative, team-based culture. Continuous Growth: Enthusiastically participate in learning sessions and be eager to grow your own skills while teaching others. Patient Advocacy: Fiercely promote our model of treating and caring for patients like they are our own family members. Required Skills & Experience: Licensure: An active, unencumbered Compact RN license OR a willingness to obtain additional state licenses as needed (for non-compact states). Experience: A minimum of 5 years of direct patient care experience. Triage Expertise: Prior clinical triage experience in an Emergency Department, Intensive Care Unit, Primary Care, or Telephonic Triage setting. Telehealth: Prior telehealth experience is required. Technical Agility: Eager to learn and able to quickly master electronic medical records (EMR), remote telephone software, and virtual video systems. Work Style: Exceptional communication and active listening skills. You enjoy fast-paced work, are eager to task-switch, and are always happy to help colleagues. Desired Skills & Experience: BSN (Bachelor of Science in Nursing) degree preferred. Experience caring for older adult populations. Experience working within population health or value-based care programs. Attributes to Success: Curious & Compassionate: You listen to others, lead with empathy, and aren't afraid to be wrong or change your mind. Detail-Oriented: You hold high standards for patient care, are well-organized, and possess meticulous attention to detail. Happy Warrior: As long as you’re in a great environment with smart, caring people working toward a common aim, you’re comfortable working hard and tackling tough challenges. Innovative: You are wired for learning and change. You want to make a difference by testing new ways of doing things to build a better care system. Agile: Agility and collaboration are critical. We are a growing organization with a start-up mentality—you believe we can do hard things together! Salary Range: $95K - $110K The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. Our Total Rewards package includes: Employer sponsored health, dental and vision plan with low or no premium Generous paid time off $100 monthly mobile or internet stipend Stock options for all employees Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles Parental leave program 401K program And more.... *Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. Founded in 2017, Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for everyone like they are family, and that includes our employees. Our robust and seamlessly integrated care platform merges advanced data and AI access with world-class clinical and service experiences to create a member experience that is unlike the industry norm. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going — all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience. Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

3 days ago

Triage Clinical Guide (Registered Nurse) - Care OnDemand

$85,000 - $110,000 / year

Job Description A bit about this role We want to help members navigate the healthcare system in a better and safer way. This means getting the right care at the right place, at the right time. As a Triage Clinical Guide (Registered Nurse), you’ll be responsible for providing telephonic advice and clinical triage when Devoted Health members call us for support. You'll serve as a fierce advocate, helping them achieve better health outcomes and connecting them with the necessary resources. Our ideal Triage Clinical Guide is caring, compassionate, solution-oriented, and enthusiastic about providing an outstanding member experience. You possess excellent clinical judgment, are ready to innovate, and are excited about changing the way healthcare is delivered. You will be joining a team of adaptable, scrappy, and resilient professionals who are proud to be part of the Devoted family, creating a revolution in care delivery. Schedule Details: This is a full-time, night shift role. You will work five (5) scheduled clinical shifts per week on a rotating basis, including weekends and holidays. Shift days are scheduled based on business needs but will primarily be: 6:00 PM – 2:30 AM ET Shift assignments are subject to change based on operational needs. Your Responsibilities & Impact: Clinical Triage: Engage with members via telephone and the patient portal to provide clinical advice, educational materials, answer questions, and direct patients to the appropriate level of care. Care Coordination: Connect members with the exact care they need, whether routing them to providers within Devoted Medical, primary care, urgent care, or emergency services. Telehealth Support: Deliver exceptional support to patients with urgent complaints across multiple geographies, leveraging video telehealth visits to keep them safely at home whenever possible. Portal Chat Monitoring: Monitor clinical chat queues and respond directly to inbound patient portal messages within established response goals. Escalate to acute clinical triage via phone for new active symptoms, create appropriate Care OnDemand support episodes, and send templated replies for non-urgent administrative or routine needs. Securely share relevant educational handouts and clinical summaries after obtaining patient consent. Interdisciplinary Collaboration: Work seamlessly alongside a multidisciplinary team—including other RNs, NPs, PAs, MDs, and medical assistants—safeguarding our collaborative, team-based culture. Continuous Growth: Enthusiastically participate in learning sessions and be eager to grow your own skills while teaching others. Patient Advocacy: Fiercely promote our model of treating and caring for patients like they are our own family members. Required Skills & Experience: Licensure: An active, unencumbered Compact RN license OR a willingness to obtain additional state licenses as needed (for non-compact states). Experience: A minimum of 5 years of direct patient care experience. Triage Expertise: Prior clinical triage experience in an Emergency Department, Intensive Care Unit, Primary Care, or Telephonic Triage setting. Telehealth: Prior telehealth experience is required. Technical Agility: Eager to learn and able to quickly master electronic medical records (EMR), remote telephone software, and virtual video systems. Work Style: Exceptional communication and active listening skills. You enjoy fast-paced work, are eager to task-switch, and are always happy to help colleagues. Desired Skills & Experience: BSN (Bachelor of Science in Nursing) degree preferred. Experience caring for older adult populations. Experience working within population health or value-based care programs. Attributes to Success: Curious & Compassionate: You listen to others, lead with empathy, and aren't afraid to be wrong or change your mind. Detail-Oriented: You hold high standards for patient care, are well-organized, and possess meticulous attention to detail. Happy Warrior: As long as you’re in a great environment with smart, caring people working toward a common aim, you’re comfortable working hard and tackling tough challenges. Innovative: You are wired for learning and change. You want to make a difference by testing new ways of doing things to build a better care system. Agile: Agility and collaboration are critical. We are a growing organization with a start-up mentality—you believe we can do hard things together! Salary Range: $85,000 - $110,000 / year The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. Our Total Rewards package includes: Employer sponsored health, dental and vision plan with low or no premium Generous paid time off $100 monthly mobile or internet stipend Stock options for all employees Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles Parental leave program 401K program And more.... *Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. Founded in 2017, Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for everyone like they are family, and that includes our employees. Our robust and seamlessly integrated care platform merges advanced data and AI access with world-class clinical and service experiences to create a member experience that is unlike the industry norm. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going — all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience. Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

3 days ago

Triage Clinical Guide (Registered Nurse) - Night Shift

$95,000 - $110,000 / year

Clinical Guide Part A: (UM) Utilization Management Nurse

$82,680 - $96,460 / year

Job Description A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team, responsible for inpatient, behavioral health, and/or post-acute authorization review in alignment with CMS and Medicare Advantage regulations. Reviews medical records to evaluate the medical necessity and appropriateness of requested inpatient and/or post-acute services in accordance with established clinical criteria and CMS guidelines. Schedule: This is a full-time, remote position working five 8-hour days. We are hiring for several schedules: Tuesday – Saturday, 9:00 AM – 6:00 PM ET Sunday – Thursday, 9:00 AM – 6:00 PM ET Monday – Friday, 11:00 AM – 8:00 PM ET Monday – Friday, 9:00 AM – 6:00 PM ET We'll ask about your schedule preference during the process and will do our best to match it. Because we are filling a limited number of openings on each schedule, availability changes as roles are filled — so we ask that candidates be open to more than one schedule where possible. Most schedules include one weekend day. Weekend and later-day coverage is a core part of how our Utilization Management team meets CMS turnaround requirements. Your Responsibilities and Impact will include: Review Medical Records: Conduct prospective (pre-service), concurrent, and retrospective utilization review to evaluate medical necessity, appropriate level of care (Inpatient vs. Observation), and post-acute services in accordance with established clinical criteria and CMS guidelines. Evaluate Treatment Plans: Assess the appropriateness, timing, and setting of requested services, ensuring alignment with medical necessity criteria and Medicare Advantage requirements. Recommend alternative levels of care when clinically appropriate. Inpatient & Behavioral Health Review: Perform initial, concurrent, and discharge reviews for inpatient and behavioral health admissions. Ensure admission status accuracy and regulatory compliance with CMS timeliness (TAT) standards. Post-Acute Review: Conduct initial authorization and concurrent review for post-acute services (SNF, LTACH, ARU, Home Health), evaluating ongoing medical necessity and appropriate length of stay. Issue NOMNC when coverage criteria are no longer met. Medical Director Collaboration: Refer cases that do not meet criteria to the Medical Director for secondary review and final determination. Prepare clinical summaries and coordinate peer-to-peer (P2P) discussions. Manage authorization reopen requests as appropriate. Resource Stewardship: Monitor utilization of inpatient and post-acute services to promote appropriate resource use while maintaining high-quality, member-centered care. Regulatory & Documentation Compliance: Maintain accurate, defensible documentation of all determinations. Ensure adherence to CMS regulations, Medicare Advantage requirements, and internal compliance standards. Required skills and experience: Unrestricted RN license with a minimum of 4 years of clinical experience 3+ years in utilization review, utilization management, case management, discharge planning, care coordination, or clinical appeals — in a health plan, hospital, or post-acute setting Familiarity with CMS regulations and Medicare Advantage requirements, or comparable payer coverage experience Experience escalating cases that don't meet criteria, including preparing clinical summaries for physician review Ability to work one of the posted schedules, including a weekend day for most schedules; flexibility across more than one schedule preferred. Able to work in a fast paced environment that is constantly evolving. Desired skills and experience: Experience with AI/LLM Certified in InterQual #LI-DS1 #LI-Remote Salary Range: $82,680-$96,460 / year The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. Our Total Rewards package includes: Employer sponsored health, dental and vision plan with low or no premium Generous paid time off $100 monthly mobile or internet stipend Stock options for all employees Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles Parental leave program 401K program And more.... *Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. Founded in 2017, Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for everyone like they are family, and that includes our employees. Our robust and seamlessly integrated care platform merges advanced data and AI access with world-class clinical and service experiences to create a member experience that is unlike the industry norm. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going — all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience. Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

2 months ago

Triage Clinical Guide (Registered Nurse) - Care OnDemand