RN Care Navigator – Hematology & Oncology

Cleveland Clinic; Cleveland (OH); On-site; USD 4,189,000 - 132,853,000; Full time

Job summary

Cleveland Clinic Hillcrest Hospital is seeking a Care Coordinator to work with a multidisciplinary team to coordinate care for high-risk patients, reduce readmissions, and improve transitions across settings.

Ideal candidates are RN with 3–5 years' nursing experience, BLS, and strong communication; BSN preferred. This on-site role runs 7:00 a.m. – 5:30 p.m. with competitive pay and benefits.

Qualifications

• Graduate from an accredited school of Professional Nursing.
• Current state licensure as a Registered Nurse (RN).
• Basic Life Support (BLS) Certification through the American Heart Association (AHA) or American Red Cross.
• Three to five years of nursing experience.
• Strong attention to detail and therapeutic communication skills.

Responsibilities

• Work collaboratively with a multidisciplinary care team across the continuum of care for high-risk patients to develop goals, plan interventions and maximize patient outcomes.
• Outlines the nature and duration of involvement needed by the specialty care team and specialty care coordinator then identifies the primary care team involved.
• Utilize technological tools (registries, patient lists, care team tab, etc.) to manage population
• Use assessment skills and tools to identify patients with actual or potential care needs that would require care coordination.
• Conducts targeted outreach to a defined panel of high risk patients to ensure timely and efficient care delivery across the continuum of care.
• Provide care and disease management coordination.
• Identify patients in the specialty care practice that have ongoing coordination needs and conduct targeted outreach.
• Conduct comprehensive clinical assessments that include disease/age-specific, medical, behavioral, pharmacy, social and end of life needs of each patient.
• Inform and work with patients and their families regarding coordination of their care, provide education and coaching, monitor patient compliance with their care plan, perform reassessments regarding patient progress toward goals, and update plan of care.
• Serve as a liaison and advocate for patients and families.
• Assist in managing transitions of care across care settings, ensuring optimal communication and planning.
• Identify barriers, facilitate solutions, and connect others to community resources.
• Define and ensure compliance with disease-specific care paths for specialty care or chronic disease.
• Work with the patients and family to assess current knowledge, health literacy, and readiness to change, utilizing teach back to assess level of knowledge.
• Coach patient and family on self-management support; including setting long and short term goals.
• Educate about managing a specialty or surgical condition (inclusive of preoperative, perioperative, postoperative and recovery) inclusive of prevention and health maintenance tasks.
• Work with practices on quality and process improvement initiatives.

Skills

RN licensure

BLS Certification

Nursing experience

Attention to detail

Therapeutic communication

Education

RN licensure

BLS Certification

Job description

Cleveland Clinic Hillcrest Hospital is seeking a Care Coordinator to work with a multidisciplinary team to coordinate care for high-risk patients, reduce readmissions, and improve transitions across settings.

Ideal candidates are RN with 3–5 years' nursing experience, BLS, and strong communication; BSN preferred. This on-site role runs 7:00 a.m. – 5:30 p.m. with competitive pay and benefits.