RN Discharge Navigator – Medical Group

Trinity Health•Mason City, IA

9d•Onsite

About The Position

At MercyOne, health care is more than just a doctor’s visit or a place to go when you’re in need of medical attention. Our Mission is based on improving the health of our communities – that means not only when you are sick but keeping you well. MercyOne North Iowa is the largest provider of health care services in our region, and we are proudly the largest employer in Cerro Gordo County. Our hospital is a private, not-for-profit health care center, licensed for 346 beds, which serves more than 400,000 inpatients and outpatients each year. In addition, MercyOne North Iowa is a teaching institution. We conduct a Family Medicine Residency, Internal Medicine Residency, Cardiology Fellowship, Hospice and Palliative Medicine Fellowship, PGY1 Pharmacy Residency and a School of Radiologic Technology. MercyOne North Iowa is a clinical training site for approximately 500 students from 127 different colleges enrolled in programs for medical laboratory, nursing, paramedic, rehabilitation, medical assistants, pastoral services, physicians and many other medical fields. Join the MercyOne Family! We are looking to hire a RN Discharge Navigator As a RN Discharge Navigator at MercyOne, you will serve as a consistent care coordinator for MercyOne clinic patients being discharged from the hospital and emergency room. The coordinator will collaborate with the care coordination and clinical teams to assure the patient needs are met and all follow-up is transitioned to the ambulatory care team. The Navigator will be the liaison with the patient, providers, care team, family and other involved parties to identify and eliminate barriers to care to achieve an optimal clinical outcome. The coordinator will also serve as a resource for patients needing to establish care with MercyOne Clinics across the region.

Requirements

Bachelor’s degree in nursing, health administration or related field required.
Iowa licensure as a Registered Nurse.
Requires a minimum of three (3) years in clinical setting.
Member of a professional healthcare organization.
Demonstrated expertise in the use of performance improvement methodology/tools.
Must be able to use computers for documentation and other relevant activities.
Demonstrates specific knowledge related to software programs such as event reporting systems, government reporting systems, and other appropriate software programs.
Experience with computer applications such as Microsoft Office Suite (Word, Excel, PowerPoint, Outlook), HealthStream, Intranet, and use of reporting tools.
Helpful to have experience with PowerChart/EPIC or similar tool.

Responsibilities

Coordinates patient care in collaboration with the acute and ambulatory care team across the continuum of care.
Manages the timely transition and follow-up post hospital discharges or emergency room visits ensuring appointments and follow up visits are scheduled.
Ensure care documents and discharge notes are accessible to the ambulatory care team to ensure seamless transition and communication.
Coordinates post hospitalization advanced imaging as needed, supporting communication with ambulatory care teams and ordering or tasking of discharge orders.
Coordinates with clinic manager for access challenges and concerns to ensure timely follow-up.
Escalates access concerns to Medical Group leadership.
Identifies and refers patients appropriate for resource referrals including care management, high risk health coaching and community health workers.
Document all patient coordination activities, education, and other interactions in designated inpatient and outpatient electronic health record systems to assure a timely, complete patient record and effective communication with other members of the care delivery team.
Assist with tracking, documentation and outcome reporting for navigation services.
Identify opportunities to develop improved processes and prevent hospitalizations, readmission and unnecessary emergency room visits.
Supports patients in establishing care with MercyOne clinics and maintaining awareness of providers with access and limitations.
Perform other duties consistent with the purpose of the job as directed.