Registered Nurse 2

About the role

The Registered Nurse 2 provides day-to-day clinical nursing support for the division, including telephone triage, clinical InBasket management, medication and treatment coordination, laboratory and diagnostic follow-up, specialty medication and infusion support, and clinical escalation. The RN works collaboratively with rheumatology physicians, the APRN, Nurse Navigator, Patient Navigators, CBORs, pharmacies, infusion services, payers, and other healthcare teams to ensure timely and safe resolution of clinical patient-care needs.

Responsibilities

• Manages and prioritizes Rheumatology clinical InBasket work, including patient calls, patient advice requests, results, staff messages, CC'd charts, refill-related clinical requests, and provider-directed clinical messages.
• Performs telephone and electronic clinical triage for patients reporting symptoms, changes in condition, medication concerns, or other clinical needs.
• Recognizes urgent or emergent symptoms and escalates appropriately to the physician, APRN, emergency services, or other appropriate level of care.
• Communicates with patients regarding provider-directed clinical recommendations, laboratory results, diagnostic testing, medications, and treatment plans within established nursing protocols.
• Reviews and coordinates medication refill requests and medication clarification requests according to established protocols and provider direction.
• Manages and escalates critical or abnormal laboratory results and other time-sensitive clinical findings.
• Coordinates clinical requirements associated with specialty medications, including documentation of medical necessity, prior-authorization clinical information, denials, appeals, and supporting documentation.
• Initiates and coordinates specialty medication appeals and supports peer-to-peer review requests, including gathering clinical history and required documentation for provider review.
• Coordinates radiology authorization denials and peer-to-peer requests requiring clinical information or provider intervention.
• Provides clinical nursing support for infusion therapy, including review of required laboratory testing, treatment-related clinical questions, infusion orders/issues, and communication with the provider and infusion team.
• Coordinates with CTU and external infusion providers regarding treatment-related clinical issues.
• Manages clinical components of site-of-care infusion denials, working with health-plan case managers, infusion RN coordinators, physicians, and approved infusion facilities.
• Coordinates specialty laboratory testing, including appropriate clinical documentation and communication with specialty laboratories when required.
• Supports Patient Assistance Program (PAP) and medication-access processes when nursing or clinical documentation is required, including