Role Description The RN TeleNurse is responsible for triaging incoming patient calls. Promotes and demonstrates leadership within the department. Promotes the philosophy of wellness; serves as a resource person, educator, and patient advocate. Job Relationships - Reports to the TeleNurse Supervisor/Manager Principal Responsibilities - Apply all phases of the Nursing Process, i.e., assessment, planning, implementation and evaluation when triaging patients. - Demonstrate effective verbal communication: communicate phone advice in a calm manner so that it is properly received and understood. - Identify life threatening emergencies; recommend appropriate interventions, including facilitation of ambulance transportation. - Demonstrate knowledge of disease processes and pathophysiology to accurately conduct an initial assessment and triage patients via telephone dialogue. - Perform data entry at the time of the call and record all significant health history of the caller. - Prioritize tasks appropriately and manage time and resources effectively. - Prioritize, delegate, and manage the acuity of incoming patient calls and staff duties as assigned. - Refer problems and concerns which require physician intervention to the On Call Physician and/or primary care physician. Direct caller/patient to appropriate level of care including, but not limited to nearest ER, office visit, or self-care. - Schedule patient appointments in scheduling system according to established and approved guidelines. - Utilize medical resources to assist in formulating the patient's plan of care. - Counsel and teach patients and/or callers according to established guidelines of practice. - Document all calls according to established guidelines of practice. - Maintain statistical data as requested. - Work effectively with minimal supervision. - Maintain confidentiality of all interactions. - Maintain knowledge by attending appropriate educational programs, reading current journals and literature. - Attend all department meetings and mandatory Springfield Clinic in-services. - Perform other job duties as assigned. - Comply with the Springfield Clinic incident reporting policy and procedures. - Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy. - Provide excellent customer service and adhere to SC Way customer service philosophy. Qualifications - RN, graduate of an accredited school of nursing with current Illinois RN licensure. - Minimum of three years of clinical experience in acute ambulatory or acute care setting. - Experience in ER, Home Health preferred. Licenses/Certificates - RN License. Knowledge, Skills and Abilities - Required to give one (1) month resignation notice. - Required to work every other weekend and 4-5 out of 9 Springfield Clinic recognized holidays per year. - Required to reside within a 100 mile radius of Springfield, IL. - Basic typing skills at 40 wpm or greater. - Demonstrates intermediate computer skills and comfort with Windows operating systems. - Pleasant, clear telephone voice. - Excellent written, verbal, and interpersonal communication skills. - Practices independent nursing consistent with the Illinois Nurse Practice Act. Working Environment - Professional office environment which requires extended periods of sitting. - Routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. - Potential to work from home. PHI/Privacy Level - HIPAA1

Role Description Provides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties - Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. - Provides coordination and processing of pharmacy prior authorization requests and/or appeals. - Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. - Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. - Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. - Assists members and providers with initiating verbal and written coverage determinations and appeals. - Records calls accurately within the pharmacy call tracking system. - Maintains established pharmacy call quality and quantity standards. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews (CMRs) through pre-work up to case preparation. - Proactively identifies ways to improve pharmacy call center member relations. Qualifications - At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Requirements - Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. - Health care industry experience. Benefits Molina Healthcare offers a competitive benefits and compensation package. Company Description Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

• As the expert for protecting the loans we arrange, you advise our customers by phone on the relevant insurance products • You assess each customer's individual needs and support them with tailored solutions using our internal systems • You take customers' personal preferences into account and ensure high customer satisfaction through a strong service orientation • This is not cold calling — all customers expect and look forward to your guidance • With our modern communication tools and the digital contract-completion options provided by our partners, nothing stands in the way of an efficient workday

Title: RN, Telephone Triage, Weekends Location: Fort Worth, TX Part time job requisition id JR-117170 Department: Telephone Triage Shift: Weekend Shift (United States of America) Standard Weekly Hours: 20 Summary: A registered nurse, who performs nursing care for the caller, patient, and family via the telephone. Works interdependently within the guidelines of medical protocols and nursing standards of performance. Uses verbal communication and data-collection skills in carrying out the nursing process. Collaborates with callers on the telephone and with colleagues in other health disciplines to meet the individual health and illness needs of the patient and family. Saturday/Sunday (10) hour shifts 8am - 6pm Orientation is Monday - Thursday 5p - 11p for 12 weeks on-site Must be local to DFW area Education: - Graduate of an accredited nursing program - 5 years pediatric experience required - 3 years pediatric ED/UCC and/or Critical Care experience preferred - Good organizational, interpersonal, communication skills & computer skills Certification/Licensure: - Current license to practice professional nursing in the State of Texas About Us: Cook Children's Medical Center is the cornerstone of Cook Children's, and offers advanced technologies, research and treatments, surgery, rehabilitation and ancillary services all designed to meet children's needs. Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer.