Nurse Navigator

WVU Medicine; Keyser (WV); In loco; USD 65.000 - 90.000; Tempo pieno

Descrizione del lavoro

PVH Potomac Valley Hospital in Keyser, WV seeks an experienced nurse for ambulatory care coordination and utilization management. You will triage calls, assess needs, and coordinate referrals, while educating patients on care options and best practices.

Strong communication and documentation are essential for maintaining a comprehensive medical record and ensuring safe transitions of care. The role requires WV RN licensure (or eNLC), BLS within 30 days, and 3 years of nursing experience; BSN and

Competenze

• Current unencumbered licensure with the WV Board of Registered Professional Nurses, or eNLC.
• Obtain Basic Life Support certification within 30 days of hire.
• Three years of nursing experience.
• Preferred BSN and five years of nursing experience.

Mansioni

• Triage callers' needs using established criteria and document accurately.
• Provide medical information using nursing background and resources.
• Identify gaps in care and coordinate referrals or telehealth visits.
• Educate patients on treatment options and assist in making informed decisions.
• Determine urgency and disposition of patient needs via telephone.
• Document all conversations to maintain a comprehensive medical record.
• Collaborate with Case management, CHWs, families, and physicians for safe transitions.
• Support ambulatory utilization management, financial management, and quality screening.
• Risk stratify patients to prioritize needs and plan interventions.
• Design individualized care plans and monitor clinical performance and outcomes.
• Use data to drive improvements and follow evidence-based guidelines.

Conoscenze

Communication skills

Adaptability

Documentation

Formazione

Bachelor of Science in Nursing (BSN)

Descrizione del lavoro

This position collaborates with patients and primary care providers to ensure patients receive quality, efficient, and cost-effective healthcare services. Responsible for triaging incoming patient calls, assessing needs, giving appropriate clinical dispositions and facilitating referrals. This position will educate the patient when appropriate regarding immediate care advice and preventative behaviors.

Minimum Qualifications

Education, Certification, and/or Licensure

• Current unencumbered licensure with the WV Board of Registered Professional Nurses, or appropriate state board where services will be provided, as a registered professional nurse OR current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC).
• Obtain certification in Basic Life Support within 30 days of hire date.

Experience

• Three (3) years of nursing experience.

Preferred Qualifications

Education, Certification, and/or Licensure

• Bachelor of Science in Nursing (BSN).

Experience

• Preferred prior care coordination experience.
• Five (5) years of nursing experience.

Core Duties and Responsibilities

• Professional assessment of callers needs using established criteria and protocols while performing accurate, concise and timely documentation.
• Use established software, online resources, written materials and nursing background to provide callers with appropriate medical information.
• Identifies problems or gaps in care offering opportunity for intervention.
• Facilitates referrals within our clinics by scheduling and coordinating either a clinic appointment, e-visit or telehealth visit with a provider.
• Supports consumers in selection of best physician and facility to maximize access, quality, and manage healthcare cost.
• Provides health education and coaches consumers on treatment alternatives to assist them in best- decision making.
• Identifies the nature and urgency of patient’s healthcare needs and determine appropriate disposition via telephone.
• Documents all conversations with patients with patients to maintain a comprehensive medical record.
• Supports team environment which allows clear communication, positive support and creative thinking.
• Communicates with Case management, Community Health Workers, patients, families, and physicians/providers to assist in safe transition of care.
• Ambulatory Utilization Management, Financial management and Quality Screening for assigned patients.
• Identifies the targeted population and risk stratifies patients to prioritize needs and direct interventions.
• Works collaboratively with patients to design an individualized plan of care that ensures coordination of services by the healthcare team.
• Clinical performance improvement, outcome management and quality activities.
• Uses data to drive decisions and plan/implement performance improvement strategies for assigned patients, including fiscal, clinical and patient satisfaction data.
• Implements clinical interventions based on risk stratification and evidence based clinical guideline adherence and promotes best practice by initiating/adjusting therapies as directed by the practitioner and providing appropriate follow-up monitoring as needed.
• Continuously evaluates laboratory results, diagnostic tests, utilization patterns and other metrics to monitor quality and efficiency results for assigned population.
• Monitors clinical and financial indicators on an ongoing basis and takes action to achieve continuous improvement in both areas.
• Works with leadership to continuously evaluate process, identify problems, and propose process improvement strategies.
• Educates multidisciplinary team and physicians about clinical pathways/protocols and managed care principles.

Physical Requirements

• Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping are necessary body movements utilized in performing duties through the work shift.
• Ability to sit for long periods of time.

Working Environment

• Office/call center setting environment.

Skills and Abilities

• Must be flexible in fast past and rapidly changing environment.
• Excellent oral and written communication skills, as well as motivated and organized with handling and maintain confidential information.

Scheduled Weekly Hours

40

Exempt/Non-Exempt

United States of America (Non-Exempt)

Company

PVH Potomac Valley Hospital

Cost Center

8880 PVH Medicine Preventive Medicine

Address

100 Pin Oak Lane
Keyser
West Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.