Cardiology Heart Failure Nurse Navigator, Full Time Days, 8a - 4p, Atlantic Health, Morristown Medical Center

Atlantic Health System•Morristown, NJ

8d•Onsite

About The Position

The Heart Failure Navigator is a specialized clinical professional responsible for coordinating and optimizing care for patients with heart failure across the continuum—from inpatient care through discharge and outpatient management. The role focuses on improving clinical outcomes, reducing readmissions, achieving LOS targets, and ensuring adherence to evidence-based heart failure guidelines. The Heart Failure Navigator facilitates seamless transitions across the continuum of care, reduces readmissions, improves compliance with guideline-directed therapy, and enhances the patient experience through education and coordinated follow-up.

Requirements

Specialized clinical professional responsible for coordinating and optimizing care for patients with heart failure across the continuum
Improving clinical outcomes, reducing readmissions, achieving LOS targets, and ensuring adherence to evidence-based heart failure guidelines
Facilitates seamless transitions across the continuum of care
Reduces readmissions
Improves compliance with guideline-directed therapy
Enhances the patient experience through education and coordinated follow-up
Identify and follows heart failure patients during inpatient admission and outpatient encounters
Coordinate multidisciplinary care (cardiology, primary care, nursing, case management, pharmacy, rehab)
Facilitate smooth transitions of care from hospital to home, rehab, or outpatient follow-up
Ensures post hospital discharge appointments are in place prior to discharge
Ensure adherence to evidence-based clinical guidelines (e.g., GDMT for heart failure)
Monitor patients for clinical deterioration and intervene early
Collaborate with providers to optimize medical therapy
Review labs, imaging, and diagnostics relevant to heart failure management
Provide education on disease process and symptom recognition
Provide education on medication adherence
Provide education on dietary restrictions (e.g., low sodium)
Provide education on daily weight monitoring and self-management
Reinforce discharge instructions and self-care plans
Develop and implement strategies to reduce 30-day readmissions
Conduct post-discharge follow-up calls or visits
Track and report quality metrics (LOS, readmissions, mortality, compliance)
Monitors LOS and develops strategies to help achieve targets
Ensure timely follow-up appointments (cardiology and primary care)
Coordinate discharge needs (home care, equipment, medications)
Address barriers to care such as transportation or medication access
Participate in heart failure program development and accreditation initiatives
Analyze data to identify trends and opportunities for improvement
Support regulatory compliance (e.g., Joint Commission, CMS metrics)
Maintain accurate documentation in the electronic medical record
Track patient outcomes and registry data
Prepare reports for leadership and quality committees

Responsibilities

Identify and follows heart failure patients during inpatient admission and outpatient encounters
Coordinate multidisciplinary care (cardiology, primary care, nursing, case management, pharmacy, rehab)
Facilitate smooth transitions of care from hospital to home, rehab, or outpatient follow-up
Ensures post hospital discharge appointments are in place prior to discharge
Ensure adherence to evidence-based clinical guidelines (e.g., GDMT for heart failure)
Monitor patients for clinical deterioration and intervene early
Collaborate with providers to optimize medical therapy
Review labs, imaging, and diagnostics relevant to heart failure management
Provide education on disease process and symptom recognition, medication adherence, dietary restrictions (e.g., low sodium), and daily weight monitoring and self-management
Reinforce discharge instructions and self-care plans
Develop and implement strategies to reduce 30-day readmissions
Conduct post-discharge follow-up calls or visits
Track and report quality metrics (LOS, readmissions, mortality, compliance)
Monitors LOS and develops strategies to help achieve targets
Ensure timely follow-up appointments (cardiology and primary care)
Coordinate discharge needs (home care, equipment, medications)
Address barriers to care such as transportation or medication access
Participate in heart failure program development and accreditation initiatives
Analyze data to identify trends and opportunities for improvement
Support regulatory compliance (e.g., Joint Commission, CMS metrics)
Maintain accurate documentation in the electronic medical record
Track patient outcomes and registry data
Prepare reports for leadership and quality committees

Benefits

Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)
Life & AD&D Insurance.
Short-Term and Long-Term Disability (with options to supplement)
403(b) Retirement Plan: Employer match, additional non-elective contribution
PTO & Paid Sick Leave
Tuition Assistance, Advancement & Academic Advising
Parental, Adoption, Surrogacy Leave
Backup and On-Site Childcare
Well-Being Rewards
Employee Assistance Program (EAP)
Fertility Benefits, Healthy Pregnancy Program
Flexible Spending & Commuter Accounts
Pet, Home & Auto, Identity Theft and Legal Insurance