RN Care Navigation Nurse

As a Care Navigation Nurse, you will be expected to collaborate and communicate effectively to coordinate patient care, ensure continuity of care, and create an exceptional patient experience for surgical patients. Initiate communication with patients upon learning they may need surgery or are going to be scheduled for surgery. Guide patients through the health care system by assisting in meeting the patient’s surgical needs and promoting quality, cost effective outcomes. Utilize the nursing process by being able to coordinate and assure the delivery of service, assess physical as well as psychological factors involved in planning the patient’s care, evaluation of the benefits and calculate a cost benefit analysis. Facilitate communication with the health care team. Have strong skills in communication, empowerment, facilitation, collaboration, problem solving, as well as being an advocate to the client. Identify and evaluate members’ surgical needs via telephone communication, claims data, referrals or any methodology excluding face-to-face interaction. Interface with providers, families and alternative resources to identify and coordinate care. Document all care navigation activities and/or interventions for applicable members as they occur in the Care Management System. Act as a resource for internal and external customers. Assume accountability for coordination and management of the assigned surgical cases until time of closure Act as an advocate for the member in the healthcare delivery system. Maintains client and subscriber confidentiality at all times. Answer incoming calls in a phone queue. Other duties as assigned. Current State of Texas RN license is required Two-Three years surgical experience (preferred) Ability to work autonomously Work is remote but must be willing to commute to the office as needed Call center experience Organizational skills, self-motivated, work independently Experience with Microsoft Office and general computer software Demonstrate leadership skills. Ability to accurately compile data and perform detailed work. Ability to maintain regular attendance. Ability to maintain confidentiality of material and information. Ability to maintain professional appearance and demeanor. Ability to work as a member of a team. Have a strong working knowledge of current health care protocols with emphasis on surgical patients. Must be able to properly interpret plan documents for utilization review, case management and health care elements.