Registered Nurse (Patient Navigator)
About The Position
Become a critical lifeline at our new community hospital! Exceptional Healthcare is seeking a Patient Navigator (RN) in Prescott, AZ. In this role you will serve as a key clinical liaison combining utilization management, care coordination, and provider support to ensure appropriate patient status determinations, medically necessary admissions, and timely transitions of care. This role operates primarily at the point of entry in the Emergency Department (ED) while conducting concurrent reviews on Inpatient and Observation patients. The ideal candidate is an experienced RN with strong analytical and communication skills focused on revenue integrity, documentation improvement, and regulatory compliance. As a vital member of our clinical team, you'll deliver exceptional care while maintaining the highest professional standards.
Requirements
- Graduate from an accredited school of nursing; BSN preferred.
- Active, unrestricted RN license in the state of Arizona (or compact equivalent).
- Minimum 2–3 years of clinical nursing experience (Emergency Department, Critical Care, Case Management, or Utilization Review strongly preferred).
- Demonstrated proficiency or strong aptitude in applying standardized utilization criteria (InterQual or similar).
- Excellent interpersonal and communication skills with the ability to present clinical information confidently to physicians.
- Proficient in Electronic Health Records (EHR) and virtual communication platforms.
- Strong knowledge of HIPAA, CMS guidelines, and utilization management regulations.
- Current BLS required.
- Ability to successfully complete a comprehensive 2-week on-site training program
Nice To Haves
- ACLS/PALS preferred.
Responsibilities
- Perform real-time triage and clinical review of Emergency Department patients using standardized criteria (e.g., InterQual) to recommend appropriate patient status (Inpatient vs. Observation).
- Collaborate directly with physicians and providers to present clinical data and secure accurate, timely status decisions.
- Conduct concurrent utilization reviews and follow-up assessments on admitted Inpatient and Observation patients.
- Identify and recommend Clinical Documentation Improvement (CDI) opportunities to accurately reflect patient acuity.
- Lead proactive discharge planning and transition coordination with patients, families, and post-acute care providers.
- Maintain accurate, timely documentation in the system per regulatory requirements.
- Educate and mentor clinical staff on utilization management principles, status criteria, and documentation best practices.
- Participate in performance improvement initiatives and demonstrate a team-oriented, solution-focused approach.
- Other duties as assigned.
Benefits
- Comprehensive health, dental, and vision insurance
- 401(k) matching and paid time off
- Career growth and leadership development opportunities
- State-of-the-art facilities and ongoing education
- Supportive team environment focused on excellence
- Opportunity to help build a new healthcare facility
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
