Nurse Navigator RN - Georgia Heart Institute GHI - Heart Failure Support - FT Days

Northeast Georgia Medical Center•Gainesville, GA

1d•Onsite

About The Position

In collaboration with hospital administrators, medical staff, and healthcare professionals, this position coordinates care and services for heart failure patients across their treatment continuum. It provides psychosocial support and lifestyle modification education to the patient and their families. This is a liaison position requiring clinical experience, self-direction, attention to detail, and patient follow-up. The ability to communicate effectively with patients, families, physicians, staff, and the public is an essential component of this position. In conjunction with physicians and other healthcare professionals, the Heart Failure Nurse Navigator is responsible for, but not limited to, facilitating interactions between patients and their physicians, providing logistical support, securing referrals, and assisting with financial and insurance issues.

Requirements

Current licensure as a RN in the State of GA
Bachelors in Nursing
Minimum of five (5) years in the practice of professional Nursing in an adult acute care clinical setting, or a minimum of five (5) years in community health, or minimum of two (2) years in a heart failure designated unit required.
Ability to plan, organize, direct and evaluate activities related to patient care, including assessment, problem-solving, collaboration, verbal, non-verbal, and written communication skills, and teaching abilities
Excellent communication and writing skills; excellent interpersonal skills; ability to work effectively in a team
Basic computer skills
Familiar with community resources and hospital processes, structure and function
Current knowledge about Heart Failure, Diabetes, COPD disease processes, treatments, therapy, diagnostics, and new technology.
Seeks and participates in formal and non-formal educational opportunities to remain current and expand knowledge base

Nice To Haves

Heart Failure Certification (CHFN) preferred or certification obtained within two (2) years from date of hire.
Successful experience in a management, supervisory, teaching or comparable position.

Responsibilities

Works together with Healthcare providers to assist in the delivery of quality, cost-effective patient care by reducing the time from diagnosis to treatment, improving patient satisfaction, improving patient outcomes by reducing readmissions and mortality.
Screen inpatient reports for heart failure patients and engage providers on potential HF education and care opportunities for identified patients.
Make patient contact and confirm patient awareness/understanding of their diagnosis and the Physician(s) treatment plan, including but not limited to the following: tests, procedures, surgeries, medications.
Guide patients through the health care system by assisting with scheduling appointments, facilitating interaction and communication with Healthcare Staff and providers, and by making appropriate referrals and recommendations for patients across the continuum of care to meet their needs from diagnosis to end-of-life issues.
Provide education and support through IP visits and 30-day post hospitalization follow-up communication.
Track interventions and outcomes through the development, implementation, and evaluation of clinical practice guidelines to identify known or potential patient care problems.
Identify and develop relationships with healthcare professionals involved in the care of heart failure patients (i.e., Physicians, APPs, Nurses, Social Work/Case Management staff, THC and other Cardiology Office staff, Home Health staff, SAR staff); provide educational opportunities to promote a better understanding of the patient navigator's role and to encourage referrals.
Identify and develop relationships with community agencies (i.e. AAHFN, HFSA, AHA, Wellness Community, Legacy Link, United Way, Mom's Meals, Meals on Wheels, NGHS Home Health) involved in heart failure/elder care that provide personal health services, financial assistance, support and education.
Teach patient education classes, deliver patient-education materials and resources to patients and providers that provide HF patient treatment; promote NGHS sponsored community education programs and participate in local Wellness initiatives to screen for hypertension, CAD and heart failure.
Provide ongoing needs assessment, including caregiver needs, and make referrals as needed to the following ancillary services, but not limited to the following: rehabilitation, financial Counselor, Dietician, mental health professionals, etc.
Act as a liaison between NGHS Heart Failure Team, the patients and Physician practices to identify potential patients for ongoing clinical HF research trials.
Administer the assessments on quality of life, depression, etc. and facilitate Advanced Care Planning as outlined in standard work.
Act as a liaison between NGHS Heart Failure Team, the patients/families and Physician practices to identify potential patients for Advanced HF Treatment and ongoing HF clinical research trials.
Participate in HF Multi-disciplinary Team and HF Readmission Task Force meetings.
Ensures the all appropriate Discharge Checklists are completed prior to discharge.