RN - Nurse Navigator - Med Surg
Company: South Texas Health System McAllen
Location: Mcallen
Posted on: July 31, 2022
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Job Description:
RN - Nurse NavigatorResponsibilities Job Summary: The ACO Nurse
Navigator is a registered nurse who functions as a liaison between
the ACO, the patient and the multidisciplinary healthcare team to
assist in developing an optimal plan of care for transitioning
Medicare patients, primarily those being discharged from hospital
inpatient or emergency department services. The ACO Nurse Navigator
assesses needs and coordinates resources within and outside the ACO
(as approved by the ACO Director) to promote optimal health
benefits and outcomes (both clinical and financial). The ACO Nurse
Navigator will provide onsite review at the local UHS Acute
facility, and establish rapport with local hospital case
management, hospitalist, ER case management, and discharge planning
staffs to expedite timely transitions of care and discharge of ACO
patients. This position requires a high frequency of contact with
the very high risk ACO patient and their care givers for education
of health promotion and self-care skills as well as facilitating
compliance with the required quality measures for all ACO patients.
A Patient Navigator will also ensure the coordination and
communication of a patient's treatment plan and general status to
all care givers during all transitions of care. This position
requires advanced nursing knowledge and expertise to identify and
implement improvement processes and the ability to direct and
implement care coordination plans both in both in-patient and
out-patient settings. Qualifications Duties and Responsibilities:
Collaborates with physicians, acute/sub-acute case management
staff, patients and deemed patient representative to identify
patient needs/resources and discharge requirements. Ability to earn
and maintain trust of patients, patient representatives, physicians
and health care providers. Identifies needs of the patient and
patient representatives and ensures sensitivity to any special
needs of the patient. Identifies high-risk patients and coordinates
resources to conserve. Facilitates problem solving and
decision-making by providing guidance, knowledge of disease
management systems, wellness resources, and supportive services and
options to the patient, patient representative and health care
providers. Timely documented communication and education with
physician, patients and patient representatives regarding
opportunities for modification of patient health risk factors.
Participates in care conferences to enhance communication and
promote continuity of care. Works closely with the ACO staff as
well as contracted vendors and support staff to facilitate timely
transitions of care. Researches service resources in the community
and elsewhere to meet patient needs consistent with plan benefits.
Prepares accurate and timely required department reports related to
utilization. Qualification and Requirements: Graduation from an
accredited nursing education program. Licensed by the State of
Texas to practice as a registered nurse. Minimum of three years of
Utilization Review/Case Management experience preferred. Recent
(within past 3 years) working knowledge of Interqual criteria and
Milliman Care Guidelines preferred. Minimum of three years in
clinical medical/surgical nursing practice within a hospital
setting. Ability to effectively communicate in English, both
verbally and in writing. Certified Case Manager (CCM) or Certified
Professional in Healthcare Quality (CPHQ) Preferred Ability to
document in different electronic health records as well as utilize
Microsoft Products
Keywords: South Texas Health System McAllen, McAllen , RN - Nurse Navigator - Med Surg, Healthcare , Mcallen, Texas
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