Care Navigator Acute - PRN

3 days ago – Be among the first 25 applicants.

Department: 34006 Navicent Health Medical Center – Patient Placement

Status: Part time

Benefits Eligible: No

Hours Per Week: 0

Schedule Details/Additional Information: As needed

Pay Range: $37.50 – $56.25

• Participates in rounds on the patient care unit with the attending physician and other members of the health care team; coordinates communication to assure collaboration and consistency in moving the patient’s care to estimated date of discharge.
• Assesses patients to determine their discharge planning and/or post‑acute transition needs. Develops the discharge plan and works with the physician to implement the plan utilizing internal and external resources to ensure a safe discharge or transition to alternate level of care. The plan addresses assessment of the patient’s physical, functional, social, and psychological status, cultural and language needs, caregiver resources, and available benefits.
• Assigns the appropriate care pathway based on clinical feedback from the physician and the diagnosis‑DRG. Ensures coordination of services among the patient’s physicians, specialists, community agencies, and vendors. Works collaboratively with physicians and the multidisciplinary team to assure communication and exchange of input related to the patient’s specific care needs.
• Assesses progress toward goals and identifies barriers to meeting goals. Prepares and maintains appropriate documentation of patient care and progress within the designated systems. Closes cases in accordance with defined case‑closure procedure in a timely manner and according to established guidelines. Refers cases for post‑discharge follow‑up to the Care Navigator – Outpatient.
• Advocates in the patient’s best interest for necessary funding, treatment alternatives, timelines, and coordination of care, with frequent evaluations of progress and goals. Continues to identify community and caregiver resources to ensure continuity of care during and after completion of the care‑management plan.
• Integrates patient‑centered care into nursing processes to include the patient and family in care decisions, incorporating evidence‑based practices to achieve safe and effective patient and process outcomes. Communicates plan of care to patient and family and solicits concerns, questions, and issues for resolution.
• Demonstrates customer‑focused interpersonal skills to interact effectively with practitioners, interdisciplinary health care team members, community agencies, patients, and families with diverse opinions, values, and religious and cultural ideals.
• Performs Utilization Management duties as indicated by the UM Plan and payer requirements. Acts as a liaison between the Precert Team and the physician.
• Performs all duties related to utilization review as mandated by Navicent Health UM plan and regulatory agencies such as DNV, CMS, Payers, DCH, etc.
• Works with physicians to establish the appropriate admission status for billing and ensures all aspects of the process are addressed from a CMS compliance standpoint. Issues the IMM notice to discharging patient.
• Monitors Care Pathways, entering clinical information into the system using an established UR criterion. Makes referrals to the UM Physician Advisors as per policy. Works with attending physicians to ensure changes to status are supported by order and documentation.
• Tracks utilization of professional services, service delays, discharge delays, etc. and reports as necessary, providing collaboration with the attending physician to work through the delays.

Education: Completion of an accredited nursing educational program; BSN preferred.

Certification / Registration / License: Current registered nursing license. Eligibility to manage patients in a facility outside of the state of application requires a compact license.

Work Experience: Minimum of three years of recent experience in acute care, home health, case management, discharge planning, or care management. Experience as a care manager preferred. Experience with IT solutions such as electronic health record, learning management, or disease/care management…