Nurse Navigator - Women's Health

About the role

Provides proactive case coordination and patient navigation for patients, including triage management, algorithm management, utilization management and resource management. Organizes services across the continuum from pre-registration through discharge from the Center to affect optimal patient outcomes, achieve continuity and quality of care, reduce costs and provide customer satisfaction.

Responsibilities

• Reviews the medical record with referring provider as soon as possible after admission-within the first12 to 24 hours.
• Applies utilization review criteria to assess and document appropriateness of admission, continued stay and level of care.
• Interviews patients and/or family members to obtain information about social, emotional, and financial factors which impact health status.
• Assesses needs for progress along department algorithm of care and continuing care or resource support following discharge.
• Responds to referrals from patients, families, physicians, hospital staff, and community agencies.
• Collaborates with patient/family and members of health care team to develop appropriate post-hospital plans for continuing care or resource support following discharge.
• Utilize all appropriate medical, social, and financial resources available to support the patient/family and to ensure smooth transition to appropriate levels of care.
• Responds to referrals from patients, families, physicians, hospital staff, and community agencies.
• Collaborates with patient/family and members of health care team to develop appropriate post-hospital plans for continuing care, to initiate referrals.
• Proactively identifies problems with utilization of resources and assures specific tests, consults etc. are done in a timely manner. Feedback is obtained and documented in the patient chart.
• Communicates as needed with Physician Advisor, assures patient is placed on clinical pathway and monitors variances from pathway as appropriate.
• Maintains current information on community resources, third party payors, and managed care environment.
• Knows of changing rules/regulations, and policies/procedures.
• Maintains established departmental policies and procedures, objectives, quality management plan, environmental and infection control standards.
• Maintains appropriate and timely documentation through medical record entries, daily logs, computer entries, and monthly statistics.
• Completes worksheets, communicates in a timely manner with physicians and coders, provides necessary statistics for data collection, and identifies case mix issues.
• Makes referrals to administrative director, medical director, quality management, risk management, infection control, and hospital departments when potential quality problems are identified.
• Refers to and consults with clinical social worker on patients with complex psychosocial/financial needs.
• Develops and maintains professional working relationship with medical staff, hospital staff, and coworkers.
• Maintains strict confidentiality at all times.
• Ensures that quality of patient care is maintained by collecting quality indicators and clinical path variance data, as well as identifying data that indicates potential areas for improvement.
• Participates actively on clinical pathway, CQL, and clinical process improvement teams. May act as team member, team leader, facilitator, or recorder.
• Provides services, supports or other assistance in a culturally sensitive manner responsive to the patient/families' beliefs, attitudes, language and behaviors.
• Provides care appropriate to each patient.
• Develop and maintain strong working relationships with all key internal stakeholders including physicians and center leadership.
• Ensure strict adherence to all established Unity processes, procedures and standards.

  Requirements

  • Current licensure as a Registered Nurse in the state of New York.
  • Graduate of an approved school of nursing, BSN strongly preferred.
  • Minimum of five years of experience in a health care setting, of which a minimum of two years has been spent in acute care setting.
  • Prior experience in women's health strongly preferred.

  Qualifications

  • BS: Nursing (Required)
  • Licenses / Certifications:
    • BLS - Basic Life Support - American Heart Association (AHA)
    • American Heart Association (AHA), RN - Registered Nurse - New York State Education Department (NYSED)

  Physical Requirements

  • M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting.

  Pay

  $80,753.00 - $110,292.00