RN Navigator

Job Details

Candidates must live in Central Oregon.

About the Role

The RN Navigator is a registered nurse who provides clinical navigation and care coordination for patients across Mosaic’s ambulatory continuum. Serving as a consistent point of contact, the RN Navigator utilizes the nursing process to deliver protocol-driven guidance, risk-stratified follow-up, and seamless transitions among primary care, specialty partners, emergency departments, and community services. The RN Navigator role is focused on high-risk patient follow-up and complex care coordination utilizing the nursing process. This role plays a critical part in ensuring seamless communication, timely follow-up, and effective navigation of care for high-risk patients with complex needs.

Responsibilities

• Coordinate the care of complex and high-risk patients using evidence-based practice.
• Support patient care needs with external partners, to deliver seamless transitions among primary care, specialty providers, and other community services.
• Provide and support urgent and complex referral management, facilitating timely and appropriate patient care.
• Perform emergency department (ED) follow-up, contacting patients based on risk stratification to support safe transitions and continuity of care.
• Coordinate care needs for patients and/or caregivers in community settings (examples: ALFs, SNFs, foster homes, residential treatment facilities).
• Provide patient and family member education on chronic disease management, acute conditions, and preventive health behaviors.
• Utilize standing orders to manage the care of patients.
• Provide patient care within scope of nursing practice and current competencies, including telephone triage.
• Document all interactions in the EHR in a timely, thorough, and accurate manner.
• Provide Population-Specific Navigation (as assigned) – adult and pediatrics.
• Participate in QI initiatives, track navigator metrics (result turnaround, follow-up completion, 30-day ED return rates) and contribute to evidence-based practice adoption.
• Maintain accurate, timely documentation aligned to nursing practice models, policies, and regulatory requirements.

Work Experience

• Minimum two years of RN clinical experience in acute or ambulatory care preferred.
• Care coordination experience in an ambulatory setting preferred.
• Experience working with pediatric patients preferred.

Education, Certification And Licensure

• Required: Associates degree; Current, unrestricted Oregon RN License; BLS/CPR Certification; Valid Oregon State driver’s license.
• PREFERRED: Bachelor of Science in Nursing (BSN).

Skills & Knowledge

• Superior nursing process skills.
• Critical thinking and problem-solving skills.
• Excellent written, verbal, telephone and interpersonal communication skills.
• Familiarity/experience with client interaction on the telephone.
• Knowledge of community resources.
• Basic typing and computer skills and comfort with Microsoft Windows operating system.
• PREFERRED: EHR experience - EPIC experience a plus.
• Fluency in Spanish preferred.
• Involvement with quality improvement processes.
• Knowledge of health insurance plans, standard office policies and procedures as well as regulatory requirements including CLIA and OSHA standards.