LVN Nurse Navigator Transitional Care Management

LVN Nurse Navigator - FT
- Days
- Transitional Care Management - 21578

US:

TX:

Edinburg | NURSING & EDUCATION | Full Time

Posted a week ago

DHR Health - US:

TX:

Edinburg
- Days

Summary:

Responsible for follow up communication and coordination for continuum of care. Responsible for addressing any barriers and will communicate with department directors and physicians as required.

• Graduate of accredited vocational nursing school.
• Current Texas licensure as License Vocational Nurse
• Minimum of two year of clinical or related hospital experience
• Ability to communicate clearly and concisely with all levels of nursing, administration, and physicians
• Demonstrated leadership experience
• Ability to read, write and speak English required
• Ability to speak Spanish preferred

• Representative challenges of this position include having a high degree of competency/experience in general.
• Requires good communication and organizational skills.
• Must Requires reasoning ability and good independent judgment.
• Must project a professional image. Working knowledge of personal computer and software applications used in job.

• Responsible for phone-based interaction with patients after discharge
• Inform patients of abnormal laboratory results
• Educate patient and/or caregiver on disease specific education
• Coordinate follow up care with Primary Care Physician or Specialist as necessary
• Identify barriers to compliance with plan of care
• Refer to Care Link Clinic when needed
• Coordinate access to clinical and community based resources as appropriate
• Respond to triggers that may indicate intervention is required
• Assists with monitoring and continually assess the success of problem resolution activities.
• Completes and maintains records for problem status for follow-up.
• Maintains and distributes corrective action reminder report to responsible persons.
• Assist with meetings and disseminates information to appropriate areas, as directed.
• Able to travel and make home visits as needed. All other duties as assigned

(Chain-of-command)

1. (Director)

Provide excellent customer service to all DHR customers. All employees are required to attend the DHR C.A.R.E.S program which outlines the Customer Service Principals including:
Commitment, Accountability, Respect, Excellence and Service.

Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status and interpret the appropriate information needed to identify each patient’s requirement relative to his or her age.

A.
Essential Duties
:
Indicated by bold print within performance standards, preceding individual numbered criteria.

• Light/moderate lifting up to 20 lbs, from the floor to shoulder height.
• Must be able to assist other employees with lifting more than 20 lbs.
• Light/moderate carrying up to 20 lbs.
• Pulling hand over hand
• Pushing
• Repeated bending
• Stooping/Bending
• Reaching above shoulder
• Climbing Stairs
• Climbing Ladders
• Dual simultaneous grasping
• Depth Perceptions needed
• Ability to see
• Identify Colors
• Operating office equipment
• Operating mechanical equipment
• Ability to read and write
• Ability to Count
• Ability to hear verbal communication without aid
• Operating Personal Vehicle
• Ability to comprehend written/verbal communication
• Other:
  Ability to deal with stress

B.
Working Conditions
:
The individual spends over 95% of his/her time in an air-conditioned…