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. Performs MMF/SNEC duties and other hurricane/disaster related activities as assigned. 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 checklist. 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. Skill General Competencies: Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines.
Ability to communicate effectively in both oral and written form. Ability to handle difficult and stressful situations with professional composure. Ability to understand and follow instructions.
Ability to exercise sound and independent judgment. Knowledge and skill in use of job appropriate technology and software applications. Management Competencies: Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
Skill in monitoring/assessing the performance to make improvements or take corrective action. Skill in using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems. Ability to plan, implement, and evaluate programs.
Ability to establish goals and objectives. Ability to recognize, analyze, and solve a variety of problems. Nursing Competencies: Ability to understand, respects and accommodates patients' preferences and needs with regards to their individual beliefs, customs and practices.
Must have ability to clearly, accurately and effectively provide information to doctors, other nurses, patients, and family members. Must have ability to show compassion, patience and maintain non-judgmental approach to patients, their families as well as other employees and customers. Unit Specific: Must have clinical knowledge, skill and ability to fully and accurately complete all required unit competencies, as indicated in the unit competency checklist.
Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources. Skill in monitoring/assessing the performance to make improvements or take corrective action. Skill in using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
Ability to plan, implement, and evaluate programs. Ability to establish goals and objectives. Ability to recognize, analyze, and solve a variety of problems.
Credentials Valid Florida RN license is required. American Heart Association and any additional applicable life support certification for Healthcare Providers may be required at the unit level 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.
Unit Specific Credential AHA Basic Life Support (BLS) with 6 months validity Working Conditions Physical Requirements - Job function requires extended standing or walking. Must be able to carry objects weighing 21 to 50 pounds. Able to lift or move objects weighing 51 to 100 pounds with the use of appropriate devices.
Jobs in this group require frequent visual acuity to perform activities related to extended use of computers. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC). Environmental Conditions - Jobs in this group are required to function in a fast-paced environment with occasional high pressure or emergent and stressful situations.
Frequent interaction with a diverse population including team members, providers, patients, insurance companies and other members of the public. Function is subject to inside environmental conditions, with occasional outdoor exposures. Exposure to various environments such as communicable diseases, toxic substances, medicinal preparations and other conditions common to a hospital and medical office environment.
May also be exposed to needle sticks, airborne infections, medical gases, X-Ray, chemical exposures and other potential hazards. Must wear Personal Protective Equipment (PPE) when exposed to infectious/clinical hospital environment. Reasonable accommodations can be made to enable people with disabilities to perform the described
. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).
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