Registered Nurse RN Patient Navigator Addiction Medicine and Recovery

Job Title

This RN Pt Navigator is critical in ensuring safe, coordinated care for patients with complex addiction and behavioral health needs.

This Navigator should have knowledge or willingness to learn Addiction & Recovery Medicine and Behavioral Health care and will serve as primary patient and caregiver contact for education, symptom management, and care plan adherence, coordinate care across inpatient, outpatient, and community settings, including psychiatry collaboration and specialty consults. Manage high-risk patient triage, medication protocols (e.g., buprenorphine inductions, alcohol withdrawal tapers), and neonatal abstinence program assessments, oversee ambulatory detox monitoring, specialty medication administration (Vivitrol), lab management, and medication reconciliation, support efforts to reduce readmissions and ED utilization through proactive follow-up and care coordination.

This is a full time (40 hours/week), salaried, day shift position. The average day starts at 0800 and ends at 1600 and is Monday through Friday. With this role, hours are dependent on patient needs and can start earlier or later on occasion. We believe in a work-life balance and will adjust accordingly if the need arises.

This position provides comprehensive care coordination, supporting a holistic and coordinated approach across the continuum of care. This position assists with informed decision-making; collaborating with a multi-disciplinary team to allow for timely screening, diagnosis, treatment and increased supportive care throughout the patient experience. This position provides individual assistance to patients, families and caregivers to help identify and overcome barriers which may hinder quality medical and psychosocial patient care.

1. Assesses the patient's plan of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through their care, facilitating options and services to meet the patient's health care needs.

2. Evaluates the medical necessity and appropriateness of care, optimizing patient outcomes. Serves as a liaison for referring physicians and assists with scheduling initial tests and consultations.

3. Assists the patient/family through diagnostic services, treatment and care. Coordinates disease care using an interdisciplinary holistic approach, making appropriate referrals and consultations in coordination with physicians and providers.

4. Ensures that the patient and family understand the diagnostic processes, care strategy and recommended actions, and are provided with appropriate information in coordination with physician and health care providers. Responds to patient requests for information regarding the disease process, expected side effects and community resources.

5. Evaluates patient's functional abilities and limitations. Determines if intervention is needed. Establishes treatment goals that are functional, measurable, patient related and reflect key limiting factors. Establishes and implements a plan of care to achieve treatment goals. Collaborates with patient and family when setting goal; initiates discharge planning. Recommends additions to or modifications of referring orders.

6. Supports the patient and family during difficult decision-making periods. Assist in coordination of end of life care for patient and family and provides emotional support.

7. Supports process improvement activities for populations of patients to achieve the optimal clinical, financial, operational, and satisfaction outcomes. Participates in staff development to maintain current standards of practice and ensure the highest quality of care.

8. Establishes and promotes a collaborative relationship with physicians, payers, and other members of the health care team. Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements.

9. This position works independently, with freedom to determine how to best accomplish functions within established procedures. This position confers with supervisor on any unusual situations. This position is facility-based with no budgetary responsibility. Internal customers include all levels of staff, including physicians. External customers include patients, families, employees of other healthcare institutions, physician offices, referring physicians, community providers and agencies, payers, provider networks, and regulatory agencies.

This position requires making decisions related to patient care coordination throughout various facilities and with various specialty practices. Decision making required for treatment and standardization of care of patients. This position requires complex problem solving related to plan of care for evaluation, treatment, and discharge planning for patients.

Must possess knowledge as normally obtained through the completion of a Bachelor's degree in nursing or related field.…