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.

• 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.
• Collaborates with the inpatient nursing staff for coordination of complex admissions/discharges.
• Collaborates with referring physicians and community outreach centers to facilitate care in urologic services.
• Collaborates with the referring provider regarding treatment plan and needed follow up.
• Participates as a member of divisional meetings for urology.
• Reviews health care information with the team, monitors the course of patients and the adherence of this course to clinical pathways or the patients' treatment plan.
• Reviews the care plan with provider, nursing staff and other members of the team as appropriate and ensures that communication is taking place with patient.
• Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned patient populations.
• Facilitates communication within the healthcare team and with the primary care provider and other disciplines to coordinate patient's progress through clinical pathways or the patient's treatment plan.
• Ensures that the sequencing and scheduling of interventions, treatment, and procedures are in accordance with the clinical pathways or the patient's treatment plan.
• Optimizes the efficiency of hospital systems which impact quality care.
• Liaison between inpatient and outpatient.
• Collaborates with other departments to accelerate scheduling and to facilitate access to tests and consultations.
• Intervenes when necessary to correct delays and to address any barriers for patients.
• Identifies trends, themes and consistent barriers and works collaboratively with the healthcare team toward resolution.
• Utilizes information obtained from various resources available to: work with preoperative 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 adhered to.
• Ensures that patients meet eligibility requirements and clinical needs for program services within established policies and procedures.
• Collaborates with the health care team to initiate referrals to the appropriate service and or provider, ensuring that adequate resources are accessible to patients.
• Ensures that all patients with abnormal test results are case managed within established policies and procedures.
• Identifies patients who are likely to have unmet insurance and resource needs and communicates with health care team members and other appropriate departments.
• Reviews various reports regularly (follow up, case management, lab results, performance indicators, billing authorizations, etc.) to ensure all services are in compliance with established policies and procedures.
• Ensures that the appropriate outside agencies are contacted and necessary referrals are initiated and followed through.
• Serves as a liaison for the referring provider for urologic services and ensures continuity of patient care for the referred patients.
• Serves as a liaison to other health care providers, including physicians, social workers, outreach workers, smoking cessation counselors, and substance abuse resources to ensure coordinated patient care.