Clinical Guide, Population Health RN

Job description

This role is located in our Denver Tech Center Office, with a hybrid schedule of 2 days onsite and 3 days remote. ABOUT THE ROLE: Under the general supervision of the Sr. Clinical Manager, the Population Health RN performs clinical triage, high-risk outreach, condition support, care planning, clinical education, and care coordination functions in supporting Rightway members with navigating, accessing, and best supporting their care needs. The Case Manager RN also serves as a trusted advisor for providing clinical guidance and directing to the most appropriate high-quality care providers with the objective of improving clinical outcomes while also reducing healthcare costs e.g. minimizing ED or other unnecessary care visits while increasing utilization of more appropriate care settings, such as primary care doctors. WHAT YOU'LL DO: - Clinical triage to assess the severity of the member’s health concerns using evidence-based protocols and algorithms in directing care to the right healthcare resource in a timely manner without compromising quality or safety - Leveraging data-driven analytics in conducting proactive outreach to engage members of clinical interest, e.g. e high-risk, hig...