Remote Nurse Navigator: Chronic Care & Care Coordination

Ascension Health; Nashville (TN); Remote; USD 80,000 - 113,000; Full time

Benefits offered by this job

Health coverage

Retirement plan

Paid time off

Tuition reimbursement

Employee assistance

Family leave

Other benefits

Job summary

Ascension Saint Thomas in Remote mode is seeking a Healthcare Professional to support chronic disease management and value-based care initiatives. This role involves coordinating care with physicians, nurses, social workers, behavioral health providers, and community partners to ensure patient-centered outcomes.

You will perform telephonic assessments to identify medical, psychosocial, and environmental needs, and manage referral workflows from automated reports.

Qualifications

• Nursing diploma required or valid professional licensure at time of hire.

Responsibilities

• Chronic Disease Management: Provide chronic disease management support for value-based care contracts across Ascension markets, including patient education and care planning.
• Patient Assessment: Conduct comprehensive telephonic assessments to identify medical, psychosocial, behavioral, and environmental needs affecting patient health outcomes.
• Interdisciplinary Collaboration: Collaborate with an interdisciplinary care team (physicians, nurses, social workers, behavioral health providers, and community organizations) to coordinate patient-centered care.
• Referral Management: Manage registry-based referrals generated through automated daily reporting.

Education

Diploma from an accredited school/college of nursing

Job description

Ascension Saint Thomas in Remote mode is seeking a Healthcare Professional to support chronic disease management and value-based care initiatives. This role involves coordinating care with physicians, nurses, social workers, behavioral health providers, and community partners to ensure patient-centered outcomes.

You will perform telephonic assessments to identify medical, psychosocial, and environmental needs, and manage referral workflows from automated reports.