Heart Failure Nurse Navigator & Care Coordinator

Tufts Medicine Integrated Network, Inc.; United States; On-site; USD 92,000 - 117,000; Full time

Job summary

Tufts Medicine Integrated Network, Inc. is seeking a Heart Failure Nurse Navigator to serve as a clinical expert, advocate, and care coordinator for CHF patients across the continuum of care.

You will support patients from hospitalization through post-discharge recovery, promoting guideline-directed therapy, education, and timely follow-up while reducing readmissions. The role emphasizes coordinating multidisciplinary teams, educating patients and families, and driving quality outcomes and

Qualifications

• Massachusetts RN Licensure.
• 3 years of acute care RN experience.
• Current Basic Life Support (BLS) Certification.
• BSN preferred.
• Experience with Cardiology/Cardiac Service Lines and/or Heart Failure Programs.
• Experience managing patients with congestive heart failure across inpatient and outpatient settings.
• Certification in Heart Failure Nursing (CHFN), Cardiac-Vascular Nursing (CV-BC), Case Management (CCM), or related specialty certification preferred.
• Experience working with multidisciplinary teams to coordinate complex patient care and improve quality outcomes.

Responsibilities

• Assesses and facilitates coordination of multidisciplinary care across the care continuum.
• Provides communication, advocacy, and education in a culturally competent manner.
• Triages new patient referrals to ensure timely access to care.
• Conducts post discharge follow up phone calls and serves as a liaison and patient advocate in navigating the healthcare system.
• Provides patient education and supports utilizing knowledge of adult learning competencies and education resources to support complete, connected, and comprehensive care.
• Collects and reports data from patient on barriers, hospital experience, health care, medications, prior treatments, etc.
• Collaborates with multidisciplinary care team and expedites sequence of patient's care.
• Serves as a liaison between patient and providers/clinicians to address patient’s needs.
• Assesses patient's needs and ensures such needs are integrated into patient’s care plan.
• Encourages and empowers patients to actively participate in decision making about their treatment and care.

Job description

Tufts Medicine Integrated Network, Inc. is seeking a Heart Failure Nurse Navigator to serve as a clinical expert, advocate, and care coordinator for CHF patients across the continuum of care.

You will support patients from hospitalization through post-discharge recovery, promoting guideline-directed therapy, education, and timely follow-up while reducing readmissions. The role emphasizes coordinating multidisciplinary teams, educating patients and families, and driving quality outcomes and