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Nurse Navigator, Ambulatory & Physician Services, Full time, Days

Jackson Health System • Full-time • Miami, Florida, United States • 2m ago

Department: Ambulatory & Physicians Services

Address: 1611 NW 12^th Ave, Miami, Florida, 33136

Shift details: Full-Time, Days

Why Jackson:

Jackson Health System is a nationally and internationally recognized academic medical system offering world-class care to any person who walks through our doors. For more than 100 years, Jackson has evolved into one of the world's top medical providers for all levels of care, no matter if it's for a routine patient visit or for a lifesaving procedure. With more than 2,000 licensed beds, we are also proud of our role as the primary teaching hospital for the University of Miami Miller School of Medicine.

Here, the best people come together to deliver Jackson's mission for our diverse communities. Our employees are committed to providing the best CARE by demonstrating compassion, accountability, respect, and expertise in everything we do.

Summary

The Outpatient Nurse Navigator is a professional member of the health care team who has accountability for the coordination, monitoring, and management of patient care resources to promote the most efficient delivery of patient care services at the appropriate level while maintaining a single high standard of care delivery to all patients. The Outpatient Nurse Navigator acts as a resource to all levels of staff in defining/educating/implementing and evaluating patient care and nursing practice standards utilizing clinical expertise, the nursing process, current concepts/principles of case management/utilization management/disease management, education, quality improvement, clinical practice and health care trends. The Outpatient Nurse Navigator provides education, counseling and information to patients who have a specific chronic condition and serves as a liaison between providers, patients and care management teams. The Outpatient Nurse Navigator performs independently and seeks support/direction as needed. The Outpatient Nurse Navigator performs specific job criteria/performance standards according to prevailing applicable Jackson Health System, professional, and regulatory standards.

Responsibilities

Performs disease management activities utilizing disease management tools and assessments. Provides disease management services for patients; including face to face, telephonic, and electronic interaction. Assesses/plans for patients care requirements for specific diagnoses and/or populations according to state and federal guidelines.
Assesses complex patient care needs/situations/acuity levels obtaining significant data from assessments (physical/functional, mental, psychosocial, environmental, family support, spiritual, cultural, financial, legal). Participates in care planning and disease management to determine appropriate interventions/referrals. Assesses patients needs to ensure services are appropriate to the condition/procedure/level of care and ensures access to care at the next level in the care continuum.
Coordinates patient care throughout an episodic/continuous course of care for a specific DRG/diagnosis/procedure/population using evidence based guidelines. Facilitates care coordination in a timely and cost-effective manner using effective negotiating skills. Evaluates/monitors the level of care (e.g. effectiveness of medications, treatments, pain status, plan) and individualizes the plan of care .
Assist patients/family to appropriately self-direct care, self-advocate, and make informed health care decisions to the degree possible in the ongoing plan of care. Coordinates with the payment source to ensure the provision of appropriate services including obtaining authorization and pre-certification as required. Monitors patients progress throughout an episode of care based on acuity and regulatory/legislative requirements.
Completes electronic documentation for case management/disease management activities. Consults with and refers cases to social worker or other health team member when appropriate. Articulates information pertinent to clinical condition, resource utilization, disease management, and level of care at team meetings/presentations, and to administration, medical directors, and physician advisors. Maintains readiness and participates in JHS JCAHO activities.
Participates in nursing and service excellence activities. Responsible for monitoring of moral hazards impacting appropriate level of care and utilization of resources. Performs monitoring and completes electronic documentation for delays in care, responding quickly to service delays. Provides referrals for support programs, educational programs, and post-acute care needs.
Follows and performs all related unit specific policies and procedures, as detailed on the unit specific competency check-list. Utilizes job and unit specific equipment as required. Demonstrates behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise). Performs all other related job duties as assigned.

Experience

Generally requires 3 to 5 years of related experience.

Education

Bachelor's degree in Nursing is required. Education requirements can be substituted with one of the following: BSN degree in progress and 3 years of nursing experience OR ASN degree with 5 years of nursing experience. Additional specialty nursing certification is highly preferred.

Credentials

Valid Florida RN license is required. American Heart Association Basic Life Support (BLS) and any additional applicable life support certification for Healthcare Providers is required upon hire with at least 6 months validity and maintenance at JHS for the duration of employment. Must meet and maintain valid and current all unit specific and organizational skills/competencies, certifications/licensures, as required by regulatory and/or nursing standard of practice for the specialty.

Jackson Health System is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, age, or any other status protected by law

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