INPATIENT NAVIGATOR, RN

3 weeks ago

AL United States Complete Health Full time
Job Description

JOB SUMMARY:

Under direction of the Director or Nurse Manager of Value Based Care, the Inpatient Navigator acts as a liaison between the patient and/or caregiver, the Transitional Care Manager (TCM), community healthcare providers, and external vendors by visiting admitted patients to discuss the hospitalization course, discharge plan, and post discharge needs with the goal of providing the patient with a positive experience that communicates care and support. As the representative of the Primary Care Provider (PCP), the Inpatient Navigator establishes communication with the patient and/or caregiver on behalf of the Care Management Team and PCP, provides follow up appointment information, and reviews the discharge plan with Case Management and/or attending physician to ensure an effective, efficient, and safe discharge will take place. Collecting pertinent information through these interactions and collaborating with the Care Management team ensures continuity of care, facilitates the ability to address Social Determinants of Health and prepares the TCM to arrange support for the patient in the post-acute setting such as transportation, meal delivery, and assistance with other social barriers.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Travel to inpatient facilities to complete rounds on Value Based Care patients.
  • Assists in providing concurrent, and retrospective review of patients during the transitional care period which begins on admission to best meet the needs of the patient and promote high-quality, cost-effective care.
  • Ensures all pertinent hospital records from hospital electronic medical record (EMR) to Athena for new admissions/discharges. Requests for inpatient and post-acute records from facilities when EMR access is limited or not obtainable.
  • Serves as a liaison between the patient, hospital staff, attending, PCP, and TCM RN.
  • Works closely with the Part A Medical Director to determine initial and subsequent patient acuity designations and assignments, ensuring that patients are transferred to appropriate care programs as needed.
  • Assesses the patient/caregivers needs and works with Case Management/TCM to ensure a safe, effective, and efficient discharge occurs.
  • Assists with obtaining DME and coordinating start of care with Home Health Agencies as needed.
  • Collaborates with the Patient Advocate, Referral Coordination, and TCM to assist patients with appointment scheduling with the PCP, specialists, and testing facilities.
  • Educates the patient on the TCM and Home Visit programs and facilitates reminders for appointments, labs, and outstanding quality improvement measures prior to discharge.
  • Interacts with respect and in a professional manner with patients, staff, and external customers.
  • Participates in pertinent meetings, workshops, seminars, and related forums as directed.
  • Other duties as assigned and directed by the Director or Nurse Manager of Value Based Care.
  • Follows HIPAA and OSHA Standards and guidelines.
  • Maintains HR compliance and procedures.
  • Ensures patient satisfaction by providing excellent service, putting Patients First, Always.

Requirements

EDUCATION AND EXPERIENCE REQUIREMENTS

Current Licensed Registered Nurse (RN), with a bachelor's degree and 2 years of related care management, disease management experience and/or training required; equivalent combination of education and experience at the discretion of the Director of Value Based Care. Utilization Review/Management experience preferred.

Experience in care management services and patient engagement is required. Knowledge of hospitals, specialists, and ancillary health services throughout the assigned geographical area is preferred.

Strong computer skills and proficiency and knowledge of Microsoft Office products and internet software is required. Able to effectively utilize an electronic health record to perform and document all patient encounters. Athena EHR experience preferred.

Ability to think critically and make decisions timely and appropriately within scope of practice.

Strong organizational, time management, and change management skills.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

KNOWLEDGE/SKILLS/ABILITIES:

The Inpatient Navigator must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.

  • Must have personal effectiveness and credibility, critical thinking, collaborative skills, communication proficiency and flexibility.
  • Must be well-versed in knowledge of chronic health conditions, acute care, behavioral health and substance abuse problems.
  • Able to work independently and in a multidisciplinary team.
  • Must be skilled in interaction with respect and in a professional manner with patients, staff and external customers.
  • Responds to requests for service and assistance in a professional and timely manner; meets commitments and is dependable.
  • Shows respect and sensitivity for cultural differences.
  • Treats people with respect; keeps commitments; inspires the trust of others; works with integrity and ethically.
  • Possesses organizational and problem-solving skills; Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions in an organized manner.
  • Uses reason when dealing with emotional topics. Skilled in de-escalation. Manages difficult or emotional customer situations effectively, strives to continuously build knowledge and skill. Has strong conflict resolution skills.

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