Nurse Navigator-Oncology Mcc

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

The Nurse Coordinator is responsible and accountable for ensuring high quality patient care that is coordinated , efficient, and supports desired clinical and financial outcomes for patients in the urology service line. In collaboration with the healthcare team, the Nurse Coordinator develops and utilizes critical pathways to ensure that specific patient outcomes are achieved and that resources are used appropriately within designated fiscal time frames.

The Nurse Coordinator participates in the ongoing evaluation of practice patterns and systems and supports efforts to improve patient care and efficiency of operations. The Nurse Coordinator interacts with the Community Health staff in identification of trends and barriers to all aspects of care: clinical, financial, and perceptual. Ability to process complex problems: identify key components and develop plan for resolution.

Ability to provide clinical /financial education to colleagues, patients and families.

• As part of the interdisciplinary health care team, coordinates and ensures the implementation of the plan of care.
• 1. Establishes a system for coordinating the care of a patient throughout the continuum of care and linkage to resources to maximize patient care for quality and safety, putting the patient first.
• 1 2. Collaborates with the inpatient nursing staff for coordination of complex admissions/discharges.
• Collaborates with the referring physicians/ community outreach centers to facilitate care in urologic services.
• 1 4. Collaborates with the referring provider regarding treatment plan and needed follow up.
• 1 5. Participates as a member of Divisional meetings for urology.
• Reviews health care information with the health care team, monitors the course of patients and the adherence of this course to clinical pathways or the patients' treatment plan
• 1 6. Reviews the care plan with provider, nursing staff and other members of the team as appropriate and insures that communication is taking place with patient.
• 1 7. Demonstrates the knowledge and skills necessary to provide care needs appropriate to the age of the patients served on his or her assigned patient populations
• 1 8. Facilitates communication within the health care team and with the primary care provider and other disciplines to coordinate patient's progress through clinical pathways or the patient's treatment plan
• 1 9. Ensures that the sequencing and scheduling of interventions, treatment, and procedures are in accordance with the clinical pathways or the patient's treatment plan
• 2. Optimizes the efficiency of hospital systems which impact quality care.
• 2 1. Liaison between in-patient and outpatient.
• Collaborates with other departments to accelerate scheduling and to facilitate access to tests and consultations.
• 2 3. Intervenes when necessary to correct delays and to address any barriers for patients
• Identifies trends, themes and consistent barriers and work collaboratively healthcare team toward resolution
• 3. Utilizes information obtained from various resources available to:
• 3 1. Work with pre-operative patients that are high risk to ensure compliance with plan of care. Collaborate with the Patient Services Manager and Medical Director to ensure appropriate standards of nursing for established workflows are adhere to.
• 3 2. Ensure that patients meet eligibility requirements and clinical needs for program services within established policies and procedures.
• 3 3. Collaborate with health care team to initiate referrals to the appropriate service and/or provider, ensuring that adequate resources are accessible to patients.
• 3 4. Ensure that all patients with abnormal test results are case managed within established policies and procedures.
• 3 5. Identify patients who are likely to have unmet insurance and resource needs and communicate with health care team members and other appropriate departments.
• 3 6. Review various reports regularly, ie; follow up, case management, lab results, performance indicators, billing authorizations, etc. to ensure all services are in compliance with established policies and procedures.
• 3 7. Ensure that the appropriate outside agencies are contacted and necessary referrals are initiated and followed through.
• 4. Serves as a liaison for the referring provider for urologic services and ensures continuity of patient care for the referred patients.
• 4 1. Serves as a liaison to other health care providers, including for example physicians, social workers, outreach workers, smoking cessation counselors, and substance abuse resources to ensure coordinated patient care.
• 4 3. Promotes the utilization of the Visiting Nurse services for urologic patients.
• Links patients with the appropriate…