Overall Purpose
As a member of the Access Center team, fields inbound calls to triage inbound calls from patients and queue patients for telemedicine providers when available.
Essential Functions
Clinical Triage & Assessment- Answer inbound patient calls, video visits, and secure messages to the telemedicine urgent care line during scheduled business hours
- Conduct focused clinical assessments by obtaining chief complaint, symptom onset and severity, relevant history, current medications, and allergies
- Apply approved evidence-based triage protocols (e.g., Schmitt-Thompson) to determine acuity and recommend the appropriate level of care
- Identify red-flag symptoms requiring emergent intervention and initiate immediate escalation, including directing patients to call 911 or proceed to the nearest emergency department
- Recognize the limits of virtual assessment and escalate to in-person evaluation when remote triage is insufficient
Disposition & Care Coordination- Assign dispositions across the full continuum: emergency care, same-day urgent care, telehealth provider visit, next-available primary care appointment, or protocol-supported home care
- Complete warm handoffs to on-call providers, advanced practice clinicians, or specialty lines as clinically indicated
- Schedule or facilitate scheduling of follow-up appointments and coordinate referrals, home health, DME, and transportation as needed
- Provide protocol-approved self-care instructions and patient education, including clear return precautions and when to seek higher-level care
- Perform outbound follow-up callbacks on high-acuity or unresolved dispositions per program standards
Documentation & Systems- Document all encounters in the electronic health record in real time, capturing assessment, protocol used, disposition, patient education provided, and patient verbalized understanding
- Verify patient identity and demographics and obtain and document telehealth consent at the start of each encounter
- Route medication refill requests, prior authorization questions, and results inquiries to the appropriate clinical owner within scope of practice
- Maintain accurate call disposition coding to support reporting, quality review, and utilization analytics
Quality, Compliance & Performance- Practice within RN scope of practice and applicable state licensure requirements, including multi-state compact licensure where required for cross-state telehealth
- Adhere to HIPAA, organizational privacy standards, and telehealth-specific regulatory and payer requirements
- Meet service-level expectations for average speed to answer, call abandonment, handle time, and documentation timeliness
- Participate in call recording review, peer review, and protocol adherence audits; incorporate feedback into practice
- Report clinical safety events, near misses, and protocol gaps through established channels
- Ensure compliance with company and CMS regulatory requirements.
- Perform other duties as assigned.
Population Health Support- Identify open care gaps, chronic condition management needs, and social barriers to care surfaced during triage encounters
- Refer eligible patients to care management, behavioral health, or disease management programs per referral criteria
- Conduct outbound telephonic check in calls for high risk program members during low in-bound call times
Schedule & Coverage- Work a scheduled Monday-Friday day shift, 8:00 a.m. to 5:00 p.m., with occasional flexibility to support coverage needs
- Participate in team huddles, staff meetings, and required competency and protocol training
Knowledge, Skills, and Abilities
Knowledge- Working knowledge of standardized nurse triage protocols and their appropriate application and documented override process
- Understanding of urgent versus emergent symptom presentation across common adult complaints, including cardiac, respiratory, neurologic, abdominal, and behavioral health
- Familiarity with RN scope of practice boundaries, particularly the distinction between protocol-based advice and independent medical decision-making
- Knowledge of HIPAA, telehealth consent requirements, and state-specific telehealth regulations
- Understanding of the local care delivery landscape - urgent care, emergency, and specialty access points - sufficient to make practical disposition recommendations
- Basic understanding of insurance coverage concepts and how benefit design affects site-of-care recommendations
Skills- Strong verbal communication skills, with the ability to elicit accurate clinical information from patients who are anxious, in pain, distracted, or providing incomplete history
- Active listening and interviewing skills sufficient to identify what the patient has not said
- Clear, concise clinical documentation completed concurrently with the encounter
- Proficiency with electronic health records, telephony and queue management systems, video visit platforms, and secure messaging
- Ability to type and navigate multiple systems while maintaining conversational engagement with the patient
- De-escalation skills for dissatisfied, distressed, or escalated callersClear, concise clinical documentation completed concurrently with the encounter
Abilities- Ability to make sound, defensible clinical judgments quickly and with incomplete information, erring toward patient safety when uncertain
- Ability to work autonomously with limited direct supervision while knowing when to escalate to a provider or supervisor
- Ability to manage sustained call volume and maintain quality and empathy across a full shift
- Ability to follow protocol consistently while recognizing the situations that fall outside it
- Ability to shift rapidly between low-acuity and high-acuity encounters without carryover
- Ability to work effectively with interdisciplinary teams, including providers, care management, scheduling, and front-office staff
- Ability to maintain composure and act decisively during emergent calls
Experience
Required Experience- Minimum 3 years of direct clinical RN experience, with at least 2 years in an acute care, emergency department, urgent care, or ambulatory setting
- Demonstrated experience performing patient assessment and prioritization without the benefit of physical examination findings, or willingness to complete formal telephone triage training
- Prior telephone triage, nurse advice line, or virtual care experience
- Experience with Schmitt-Thompson or comparable published protocol sets
- Experience with Medicare Advantage or managed care populations
- Familiarity with care gap identification and referral to care management, disease management, or behavioral health programs
Education
Required Licensure & Education- Current, unrestricted Registered Nurse license in the state of practice
- Compact (eNLC) multistate licensure, or willingness to obtain licensure in additional states within a defined timeframe
- Associate degree in Nursing required; BSN preferred
- Current BLS certification
Pay Range: $80,000-92,000 depending on experience
