RN Nurse Navigator

Highmark Health•Erie, PA

About The Position

The RN Nurse Navigator serves as a consistent point of contact for referring physicians, patients, caregivers, families, and the community. The role facilitates patient flow by coordinating appointments and helping patients access clinical and supportive care services within the Network. In collaboration with the multidisciplinary team, the navigator coordinates all aspects of care for adult patients within a specialized disease state to support quality, comprehensive services. The role also identifies community needs and provides education, screening, support, referrals, care coordination, and other necessary assistance. The position adheres to the ethical, legal, and behavioral standards established in the company’s code of business conduct and policies. Employees must protect confidential information and comply with HIPAA, company privacy and information security policies, applicable laws and regulations, and required training. The company prohibits discrimination against qualified individuals based on protected veteran or disability status and against individuals based on other categories protected by applicable law.

Requirements

Current Pennsylvania RN licensure or current multistate licensure through the enhanced Nurse Licensure Compact (eNLC).
1–3 years of nursing experience in the specialty.
American Heart Association CPR.
Act 34 Criminal Background Clearance Certificate.
Act 33 Child Abuse Clearance Certificate.
Act 73 FBI Fingerprinting Criminal Background Clearance Certificate.
A valid Pennsylvania driver’s license may be required.
Older Adults Protective Services Act (OAPSA) clearance may be required depending on location.

Nice To Haves

Bachelor’s degree in Nursing.
Certification in area of expertise.

Responsibilities

Oversee community outreach, high-risk populations, and disease-specific sites to establish and sustain working relationships across the Network, including with health plans, physicians, office staff, social services staff, financial counselors, and dieticians.
Educate patients and coordinate care related to diagnoses, treatment options, treatment plans, clinical trial information, and available resources.
Coordinate safe handoffs and care between facilities and between inpatient and outpatient settings; work with High-Risk Care Teams to reduce readmissions.
Work with or assist registry staff with data collection, patient outcomes, and updates to care delivery models, as applicable.
Coordinate appointments involving the multidisciplinary team and supportive care services, and accompany patients to appointments as needed.
Ensure medication adherence issues are addressed.
Work with AHN physician offices and facilities to identify at-risk patients and facilitate appropriate screening processes.
Trend navigation-program data and outcomes, and identify gaps and opportunities to improve patient care across the continuum.
Develop or attend clinical care conferences to report on active patients to the multidisciplinary team.
Identify bereavement needs of families and develop a plan of care, as applicable.
Perform other duties as assigned or required.
Comply with the company’s code of business conduct, policies, applicable laws and regulations, privacy and information security requirements, HIPAA, and required training.