Nurse Navigator

WVU Medicine

18d•Onsite

About The Position

This position collaborates with patients and primary care providers to help ensure patients receive quality, efficient, and cost-effective healthcare services. The Nurse Navigator triages incoming patient calls, assesses needs, provides appropriate clinical dispositions, and facilitates referrals. The role also educates patients about immediate care advice and preventive behaviors when appropriate. The position uses established criteria, protocols, software, online resources, and nursing knowledge to assess callers, provide information, document interactions, identify care gaps, coordinate services, and support safe transitions of care. It works with patients and multidisciplinary healthcare teams to coordinate individualized care, manage utilization and quality, and use clinical, financial, and patient-satisfaction data to guide interventions and improvement efforts.

Requirements

Current unencumbered registered professional nurse licensure with the WV Board of Registered Professional Nurses, or the appropriate state board where services are provided, or current multistate licensure through the enhanced Nurse Licensure Compact (eNLC).
Obtain Basic Life Support certification within 30 days of hire.
Three years of nursing experience.
Flexibility in a fast-paced and rapidly changing environment.
Excellent oral and written communication skills.
Motivation and organization in handling and maintaining confidential information.

Nice To Haves

Bachelor of Science in Nursing (BSN).
Prior care coordination experience.
Five years of nursing experience.

Responsibilities

Assess callers’ needs using established criteria and protocols, documenting accurately, concisely, and promptly.
Use established software, online resources, written materials, and nursing knowledge to provide appropriate medical information.
Identify problems or gaps in care that may present opportunities for intervention.
Facilitate referrals within clinics by scheduling and coordinating clinic appointments, e-visits, or telehealth visits with providers.
Help consumers select physicians and facilities to maximize access and quality while managing healthcare costs.
Provide health education and coach consumers about treatment alternatives to support informed decisions.
Determine the nature and urgency of patients’ healthcare needs and provide an appropriate telephone disposition.
Document patient conversations to maintain a comprehensive medical record.
Support a team environment characterized by clear communication, positive support, and creative thinking.
Communicate with case management, Community Health Workers, patients, families, and physicians or providers to assist with safe transitions of care.
Perform ambulatory utilization management, financial management, and quality screening for assigned patients.
Identify target populations and risk-stratify patients to prioritize needs and direct interventions.
Collaborate with patients to design individualized care plans that coordinate services across the healthcare team.
Participate in clinical performance improvement, outcome management, and quality activities.
Use fiscal, clinical, and patient-satisfaction data to make decisions and plan and implement performance-improvement strategies for assigned patients.
Implement clinical interventions based on risk stratification and evidence-based guideline adherence; promote best practices by initiating or adjusting therapies as directed by a practitioner and providing appropriate follow-up monitoring.
Continuously evaluate laboratory results, diagnostic tests, utilization patterns, and other metrics to monitor quality and efficiency for assigned populations.
Monitor clinical and financial indicators and take action to achieve continuous improvement.
Work with leadership to evaluate processes, identify problems, and propose process-improvement strategies.
Educate multidisciplinary teams and physicians about clinical pathways, protocols, and managed-care principles.