RN Nurse Navigator - Care Connect

General Overview

This job consists of working in a high-volume, fast-paced call center environment in which a nurse assists all callers—such as referring physicians, patients, caregivers, families, and the community—with coordination of patient services through clinical triage and scheduling. The nurse facilitates patient flow, including the coordination of appointments and assists patients with accessing clinical and supportive care services within the Network. This role coordinates focused aspects of care in collaboration with the multidisciplinary team for adult/ pediatric patients to ensure they receive quality and comprehensive services.

The nurse identifies caller needs and provides education, screening, support, referrals, coordination of care, and any other assistance identified as necessary.

• Greeting patients via telephone in a pleasant and professional manner; prioritizing patient inquiries; ensuring accurate demographic and payor information is correctly reflected in the billing system; maintaining a positive customer service attitude when dealing with the public and AHN personnel; working effectively as a team member. (25%)
• In a call center setting, provide professional nursing assessments, prioritize treatments according to the urgency of need, and collaborate with other departments to appropriately coordinate patient services. (20%)
• Assist non-clinical staff with clinical issues and questions. (20%)
• Coordinate appointments including aspects of the multi-disciplinary team (physicians, consults, supportive care services, etc.). (10%)
• Work with AHN physician offices/facilities to identify at-risk patients and assist in facilitating appropriate screening processes. (10%)
• Work inbound or outbound call projects as assigned. (10%)
• Perform other duties as assigned or required. (5%)

• Minimum High School / GED
• 1 year of Nursing in the specialty
• Act 34 Criminal Background Clearance Certificate (includes Act 33 Child Abuse Clearance Certificate, Act 73 FBI Fingerprinting Criminal Background Clearance Certificate)
• Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC)
• CPR certification
• Preferred Bachelor's Degree in Nursing
• 1 year in an Emergency Room/ICU role
• 1 year with adult medicine/surgery
• 1 year in call center or tele-health setting
• Certification in area of expertise
• Valid PA driver’s license may be required
• Older Adults Protective Services Act (OAPSA) clearance may be required depending on location

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

Pay Range Minimum: $34.29 Pay Range Maximum: $54.25