RN Care Navigator

Humana • Henderson, NV

257d • $71,100 - $97,800 • Onsite

About The Position

Be a part of our caring community and help us put health first. Working within an interdisciplinary care integration team (CIT), the Care Navigator - Registered Nurse is responsible for proactively engaging patients and implementing targeted interventions to address whole person health and increased access to care. The Care Navigator - Registered Nurse will provide guidance and oversight of care coordination efforts to other members of the team, and manage clinical escalations as indicated. This role requires an understanding of how socio-economic stressors can impact ability to engage in healthcare and subsequent health outcomes. Experience will ideally include prior care or case management work with transitions of care and high-risk patient management programs in partnership with PCP care team members including community health workers, pharmacists, and behavioral health specialists.

Requirements

• Registered Nurse (RN license)
• Minimum of 4 years of experience working in health care services and navigating community-based resources

Nice To Haves

• Experience working in care/case management
• Prior value-based care experience and working with complex Senior populations
• Experience working effectively within interdisciplinary teams
• Bilingual in English and Spanish with the ability to speak, read and write in both languages without limitations or assistance

Responsibilities

• Conduct Transitions of Care Management for a subset of the patient population, including hospital, obs, and post-acute care follow ups
• Provide triage guidance and supportive consultation to other team members, handling escalated complex cases
• Develop care plans leveraging 5Ms Geriatric best practice framework
• Develop a holistic view of patient needs related to Social Determinants of Health
• Identify existing barriers to engagement with necessary resources and supports
• Provide education around maintenance of chronic health conditions, as well as available options for behavioral care and social support
• Serve as liaison between the patient and the direct care providers, assisting in navigating both internal and external systems
• Initiate care planning and subsequent action steps for high-risk members, coordinating with interdisciplinary team
• Supporting patients' self-determination, motivate patients to meet the health goals they have identified
• Refer patient to necessary services and support across the interdisciplinary team
• Lead Interdisciplinary CIT Team Meetings when indicated
• Assess patient's family and caregiver system, and conduct family meetings with patient and family when needed
• Participate in creation and facilitation of team training content
• Participate in and lead CIT interdisciplinary review of and coordination around complex patients
• Maintain patient confidentiality in accordance with HIPAA
• Document patient encounters in medical record system in a timely manner
• Follow general policies related to fire safety, infection control and attendance
• Perform all other duties and responsibilities as required

Benefits

• Medical, dental and vision benefits
• 401(k) retirement savings plan
• Paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave
• Short-term and long-term disability
• Life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree