Presbyterian Healthcare Services

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at Presbyterian Healthcare Services

Posted: 10/16/2020
Job Reference #: 14236

Job Description

Requisition ID
Default: Location : City
Location : Name
9521 San Mateo NE Albuquerque, NM 87113-2237
Default: Location : State/Province (Full Name)
New Mexico


Job Description
Type of Opportunity: Per Required Need
FTE: 0.001000
Exempt: No
Work Schedule: Varied Days and Hours

Performs clinical triage and review of inbound member and patient calls to the PHP Nurse Advice Line to ensure that services rendered to customers meet clinically appropriate direction and triage. Utilizes clinical skills to coordinate, document, and communicate all aspects of the appropriate clinical advice and triage based on criteria and in adherence to adopted protocols. Clinical triage includes all levels of acuity of medical presentations. Assists callers and members with coordination of care to in plan providers and appropriate urgent and emergent care. Validates and interprets medical information from callers using evidence-based criteria sets. Consults with PHP medical directors on non-emergent cases where protocols are not clear. Refers callers of various acuities to venues of care-- including primary care, urgent or emergent care, ALS services, or public health services such as Poison Control Center or Public Health Department. May work varied shifts and performs occasional on-call assignments.


*Receives, triages, verifies, and processes requests for clinical triage and medical advice from health plan members and their representatives. Callers may have varying degrees of acuity in presentation and symptoms presented.
*Uses clinical protocols to assess advice to callers, and documents discussion and information relayed.
*May work with stakeholders and primary and specialty providers across the state to identify most appropriate direction of care based on call. Uses critical thinking to gauge risks, determine acuity of caller s situation and make evidence based decisions on information and advice provided.
*Legally documents all calls and information discussed. Records and refers all pertinent information accordingly.
*May collaborate with other resources such as behavioral health clinicians or crisis staff to best direct callers.
*Advises manager of trends in calls and potential quality of care and legal issues.
*Communicates effectively with providers, PHP medical directors, PCSC staff, and other applicable PHS departments to deliver sound and appropriate advice.
*Must adhere to protocols and processes for compliance of call processing, documentation, transfer and follow up.
*Meets departmental and/or regulatory turnaround times for clinical triage and internal Service Level Agreements. (SLA) while maintaining productivity and quality standards.
*Performs other functions as required.


Associates degree, bachelors preferred. New Mexico Board of Nursing RN License with Multi-State Compact Licensure status required, with at least 3 years of RN experience in clinical setting, emergency medicine, urgent care, or managed care experience. Organizational and Analytical skills: Experienced analytical skills as applicable to interpret medical records. Experience with detailed research, coordination and organizational skills. Demonstrated critical thinking skills as evidenced by experience, education, and/or the pre-hire interview process.

Competencies and skills:
* SKILL-Ability to effectively interact with customers to understand their needs and explain data
* SKILL-Microsoft Office
* SKILL-Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, and physician office staff using strong dialogue and customer service competencies.
* SKILL-Written communication


Benefits are effective day-one (for .45 FTE and above) and include:

  • Competitive salaries
  • Full medical, dental and vision insurance
  • Flexible spending accounts (FSAs)
  • Free wellness programs
  • Paid time off (PTO)
  • Retirement plans, including matching employer contributions
  • Continuing education and career development opportunities
  • Life insurance and short/long term disability programs

About Us
Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees.

Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans.

We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.

About New Mexico
New Mexico's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque's International Balloon Fiesta, Los Alamos' nuclear scientists, Roswell's visitors from outer space, and Santa Fe's artists, and you get an eclectic mix of people, places and experiences that make this state great.

Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC.

New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

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