Discharge Nurse Navigator

Grady Health System; Atlanta (GA); On-site; USD 75,000 - 105,000; Full time

Benefits offered by this job

Health & Wellness

Financial Security

Work-Life Balance

Career Growth

Employee Support

Job summary

Grady Health System is seeking a Nursing Discharge Navigator to coordinate safe, efficient discharges for patients, with a strong focus on Heart Failure. You will arrange follow-up care, reconcile medications, educate patients, and ensure transportation is in place.

This role requires a Georgia RN license and 3+ years of clinical nursing experience, including nurse case management. Collaboration with care teams and ongoing quality improvement are essential parts of the position.

Qualifications

• Bachelor in Nursing is required.
• GA RN license is required.
• 3+ years of clinical nursing experience; nurse case management experience preferred.

Responsibilities

• Coordinate and schedule follow‑up appointments with care providers prior to discharge.
• Conduct discharge phone calls to assess understanding and needs.
• Ensure prescriptions are reconciled, called in, and accessible before discharge.
• Provide comprehensive discharge education including meds, symptoms, diet, weight, and red flags.
• Confirm transportation arrangements are secured prior to discharge.
• Collaborate with physicians, case management, pharmacy, social work, therapy services and other departments.
• Identify barriers early in hospitalization that may delay discharge.
• Work with the team to streamline discharge processes and reduce LOS for Heart Failure patients.
• Support Heart Failure management initiatives to reduce readmissions and improve outcomes.
• Document discharge coordination activities in the medical record in a timely manner.
• Track quality metrics related to LOS, readmissions, and follow-up compliance.

Skills

Nurse case management

Clinical nursing

Education

Bachelors in Nursing

GA RN license

Job description

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you.

Job Summary

The Nursing Discharge Navigatoris responsible forcoordinating andfacilitatingsafe, efficient, and patient-centered discharges. This role ensures continuity of care by arranging follow-up appointments, completing post-discharge outreach, coordinating prescriptions, providing comprehensive discharge education, and confirming transportation arrangements prior to discharge.

A key focus of this position is proactively supportingtimelydischarge planning to reduce length of stay, particularly for patients with Heart Failure, whilemaintaininghigh-quality outcomes and reducing readmissions.

• Coordinate and schedule follow-up appointments with primary care providers and specialists prior to patient discharge.

• Conduct discharge phone calls to assess patient understanding, answer questions, address concerns, and ensure post-discharge needs are met.

• Ensure prescriptions are reconciled, called in, and accessible to patients prior to discharge.

• Provide clear and comprehensive discharge education, including medication instructions, symptom monitoring, dietary guidance, weight monitoring, and when to seek medical attention.

• Confirm transportation arrangements are secured prior to discharge to ensure safe return home.

• Collaborate with physicians, case management, pharmacy, social work, therapy services, and other departments to support safe andtimelytransitions of care.

• Identifyand address potential barriers early in the hospitalization that may delay discharge.

• Work proactively with the interdisciplinary team to streamline discharge processes and decrease length of stay for Heart Failure patients through early education, medication coordination, and post-discharge planning.

• Support Heart Failure management initiatives aimed at reducing readmissions and improving clinical outcomes.

• Document discharge coordination activities accurately andtimelyin the medical record.

• Track and support quality metrics related to length of stay, readmissions, and follow-up compliance.

Qualifications:

• Bachelors in Nursing

• 3+ years of clinical nursing experience

• Nurse case management experience

• GA RN license

Core Competencies

These competencies reflect the values and behaviors expected of all Grady team members, regardless of role. They ensure that every employee contributes to safe, high-quality care, positive patient experience, and a collaborative work environment.

1. Patient-Centered Care - Demonstrates a commitment to delivering safe, compassionate, and high-quality care that prioritizes the well-being and satisfaction of patients and their families.
2.Integrity & Accountability - Acts ethically, maintains confidentiality, and accepts responsibility for actions, decisions, and outcomes.
3.Collaboration & Teamwork - Builds positive relationships, works effectively across departments, and supports colleagues to achieve shared goals.
4. Communication - Communicates clearly, respectfully, and effectively with patients, families, colleagues, and leadership.
5.Respect & Inclusion - Creates an inclusive environment by valuing diversity, treating others with dignity, and ensuring equitable care and opportunities for all.
6. Quality & Safety - Adheres to best practices, regulatory standards, and policies to ensure safe, reliable, and high-quality outcomes.
7. Adaptability & Resilience - Responds effectively to change, remains flexible in dynamic situations, and demonstrates resilience under pressure.
8. Continuous Improvement - Seeks opportunities to improve processes, skills, and outcomes through innovation, learning, and feedback.
9. Leadership & Professionalism - Inspires, guides, and develops individuals and teams while modeling professionalism, fairness, and transparency.
10. Employee Experience Focus - Champions a supportive and engaging employee journey that enables staff to thrive and, in turn, deliver exceptional patient care.

Grady Total Rewards

At Grady, we believe in supporting the health, well-being, and growth of every team member. Our Total Rewards package is designed to provide competitive pay and comprehensive benefits that make a difference in your life and career, including:

• Health & Wellness: Medical, dental, vision, and prescription drug coverage.

• Financial Security: Retirement savings plans with employer contributions, life insurance, and disability coverage.

• Work-Life Balance: Paid time off, holidays, and family leave benefits.

• Career Growth: Tuition reimbursement, professional development programs, and opportunities for advancement.

• Employee Support: Employee Assistance Program (EAP), wellness initiatives, and discounts on services.

Grady's Total Rewards are designed to ensure our employees feel valued, supported, and empowered, both at work and beyond.

Why Join Grady?

Grady Health System is more than a hospital - we are a vital part of Atlanta and the surrounding communities. For over 125 years, Grady has been committed to providing exceptional care, advancing health equity, and making a difference in the lives of those we serve. When you join Grady, you become part of a team that values excellence, compassion, innovation, and collaboration.

Here, every role matters. Whether you provide direct patient care, support our operations, or lead teams, you play an important part in fulfilling our mission. We offer opportunities to learn, grow, and build a meaningful career in an environment where your contributions are recognized and valued.

At Grady, we don't just work, we make an impact.

Equal Opportunity Employer Statement:

Grady Health System is proud to be an equal opportunity employer. We are committed to fostering a workforce where all employees feel valued, respected, and empowered to succeed. We prohibit discrimination and harassment of any kind based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected characteristic.

Grady is dedicated to creating an accessible work environment and provides reasonable accommodations to qualified individuals with disabilities to ensure equitable opportunities for success.