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Registered Nurse
1 month ago
Compensation / Benefits
- $25.74-$42.03/hr., based on previous work experience.
- Benefits include medical, dental, vision, short-term disability, long-term disability, life insurance, paid time off (PTO), paid holidays, tuition reimbursement, scholarship opportunities, retirement plans, free parking, and opportunities for advancement
The Transition of Care team provides disease management, care coordination and patient outreach across the care continuum. The team consists of highly skilled nurses who follow patients care for a minimum of 30 days after a hospital discharge. The team ensures that the patient receives the right care, for the right amount of time at every level of service to achieve the best outcome possible.
Responsibilities:- The Transition of Care Nurse Navigator is responsible for providing disease management, care coordination and patient outreach across the care continuum.
- Collaborates with post-acute providers (home health care, skilled nursing facility, physicians etc.) to improve patient outcomes and reduce preventable hospital readmissions, Medicare Spending per Beneficiary and other goals estabilshed by NRHS.
- In addition, the Navigator provides quality metrics, program metrics, recommendations for program enchancement and develops and leads education and training for Post Acute Providers that support the goals of NRHS.
- Direct patient care and transitional care may also be provided.
- Works closely with clinical staff to meet inpatient needs and goals to maximize effective transition of care.
- Coordinates and leads multi-disiplinary and cross continuum meetings to ensure all providers across the care continuum are working in a coordinated effort.
- Supervises a team of nurses and social worker, in the absence of the Transition of Care Supervisor.
- Resolves complex medical concerns and/or Social Drivers of Health that require triage, coordination and communication both within NRHS, Post Acute partners and both community and governmental entities.
- Accepts referrals from various NRHS departments, including NRC survery alerts, for resolution of complex problems which require high level problem solving and the coordination across the care continuum.
Education
- BSN required (or other equivalent Bachelor's level of education) but will accept Associates Degree in Nursing with BSN completion within 12 months of hire.
Experience
- Requires 3 years experience as an RN, Prefer 1-2 years of case management or care transition experience.
(Above requirements can be met by the equivalent combination of education and experience).
Licensure / Certification
- Current, unrestricted RN license in the state of Oklahoma,
- Basic Life Support (BLS) training or retraining is required and must be maintained for the duration of employment.
