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RN Patient Navigator Lead
2 months ago
The Registered Nurse Patient Navigator Lead is a key role within CHRISTUS Health, responsible for providing health and wellness coaching, case management services, and analysis of CHRISTUS services. This position plays a critical role in monitoring cases and claims, analyzing biometric and health risk assessment data, and organizing disease management programs.
Key Responsibilities- Develop and implement an integrated medical benefit program, including case management and health/disease management.
- Establish a system for coordinating patient care throughout the continuum of care.
- Use standard tools, databases, and methodologies to support the health benefit program and provide leadership in managing cases, events, and diseases.
- Interact with providers and plan members in case management medical activities to provide efficient and effective service.
- Identify targeted chronic diseases/high risk individuals and develop programs to reduce financial and health risks.
- Monitor and evaluate the effects of case management on the patient population.
- Create outcomes-management focus by interdisciplinary analysis of clinical, financial, and satisfaction elements.
- Assist in the analysis of demographics, utilization, and reimbursement.
- Prepare cost analysis and other reports to determine the reasonableness of claim/cost data and utilization rates.
- Associate's Degree in Nursing
- 5 to 7 years of experience
- RN License in state of employment or compact
- BLS
