Chronic Care Navigator RN – Case Management

Methodist Health System; Texas; On-site; USD 75,000 - 110,000; Full time

Job summary

The Methodist Health System in Texas seeks a Beneficiary Care Navigator to coordinate care for patients with chronic diseases, collaborating with clinicians, payers, and support staff to improve health outcomes.

This role emphasizes SMART goal setting, self-management coaching, timely follow-up, and thorough documentation, while promoting patient empowerment and access to community resources; bilingual English/Spanish is a plus. The position supports a full-time schedule based in Texas (M-F).

Qualifications

• Bachelor of Science in Nursing preferred or equivalent professional experience in provision of Primary Care with this population is highly desirable.
• Excellent communication and interpersonal skills. Good oral, written and presentation skills. Bilingual (English/Spanish) a plus.
• Advanced Cardio Life Support Certification preferred.
• Current Basic Life Support Certification required
• Current license to practice professional nursing in the state of Texas required.

Responsibilities

• Assess barriers when patient has not met treatments goals, is not following treatment plan of care, or has not kept important appointments.
• Assist patients in setting SMART goals for self–management, teaching them how to do self-management tasks and report abnormal findings to their physician team.
• Collaborate with payer Case Managers for additional services when appropriate.
• Collaborate with physicians, providers, and practice staff in identifying appropriate patients for care management.
• Collaborate with the patient, physician, and other care team members in assessing the patient’s progress toward individual health care goals.
• Consistent documentation of patient self-management measures, mutually agreed upon care plan that is efficiently available to all and reporting of progress towards goals.
• Develop a list of medical supply and community resources available to patients and maintains collegial relationships with the entities used most frequently.
• Overseen the development, procurement, and adoption of patient self-management educational resources used by the primary clinical teams.
• Promote patient self-management and empowers patients/families to achieve maximum levels of wellness and independence.
• Provide follow-up contact with patient as indicated to ensure compliance with recommendations — medications, lab/x-ray, specialist visits, PCP visits, dietitians, CDE, etc.
• Responsible for being available to provide telephone advice per protocol, handle urgent calls and emergent calls.
• Utilize the Institute for Healthcare Improvement (IHIs) Chronic Care Model as foundation and framework for chronic illness care management.
• Other job duties as assigned.

Skills

Nursing

Care coordination

Interpersonal skills

Bilingual English/Spanish

Education

BSN or higher

Licensed RN in TX

Job description

The Methodist Health System in Texas seeks a Beneficiary Care Navigator to coordinate care for patients with chronic diseases, collaborating with clinicians, payers, and support staff to improve health outcomes.

This role emphasizes SMART goal setting, self-management coaching, timely follow-up, and thorough documentation, while promoting patient empowerment and access to community resources; bilingual English/Spanish is a plus. The position supports a full-time schedule based in Texas (M-F).