RN Nurse Navigator - Clinically Integrated Network - PGH Region - Hybrid

Allegheny Health Network; Pittsburgh (Allegheny County); Hybrid; USD 70,000 - 85,000; Full time

Job summary

Join a leading health network as an RN Nurse Navigator to enhance care delivery in Pittsburgh. This hybrid role involves collaborating with primary care practices to improve outcomes for Medicare beneficiaries, focusing on self-management support and care coordination. Engage in community outreach and work with diverse healthcare teams to optimize patient experiences and ensure comprehensive services.

Qualifications

• Registered Nurse with 1-3 years of experience in specialty required.
• CPR certification, Act 34/33/73 clearances needed.
• Preferred: Valid PA driver's license and certification in area of expertise.

Responsibilities

• Coordinates patient care within a multidisciplinary team.
• Trends data and patient outcomes to improve navigation programs.
• Educates patients on treatment options and resources.

Skills

Collaboration

Patient management

Care coordination

Self-management support

Education

Bachelor's Degree in Nursing

Job description

RN Nurse Navigator - Clinically Integrated Network - PGH Region - Hybrid

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Company

Allegheny Health Network

Job Description

New Oppurtunity!

• This position offers an exciting opportunity to work closely with AHN and independent primary care practice teams participating in AHN's Clinically Integrated Network (CIN) to enhance the quality and value of care delivered to Medicare beneficiaries.
• You will collaborate with practices to assist patients with self-management support, disease management, and care coordination to help them meet their health goals.
• This role supports a new value-based reimbursement model for Medicare beneficiaries focused on improving population health, quality, and patient experience.
• This is a hybrid role that involves both on-site and remote work. Services will be provided at primary care practices as well as telephonically. Regional travel to CIN primary care practices is required.
  
  

General Overview

Serves as the consistent point of contact for referring physicians, patients, caregivers, families, and the community. Facilitates patient flow, including coordination of appointments and assists the patient with accessing clinical and supportive care services within the Network. The RN Nurse Navigator coordinates all aspects of care in collaboration with the multidisciplinary team for all adult patients within specialized disease state to ensure they receive quality and comprehensive services. Identifies community needs and provides education, screening, support, referrals, coordination of care, and any other assistance identified as necessary.

Essential Responsibilities

• Oversees community outreach, high risk populations and disease specific sites to establish and sustain working relationships within the network (health plan, physicians, office staff, social services staff, financial counselor, dietician, etc.).
• Educates and coordinates care regarding patient's diagnosis, treatment options, course of treatment, clinical trial information and resources available.
• Works with health care team to ensure safe handoff, coordination of care between facilities as well as inpatient to outpatient or outpatient to inpatient coordination of care. Works with High-Risk Care Teams to reduce re-admissions. May work with and/or assist Registry staff with data collection, patient outcomes and updates care delivery models.
• Coordinates appointments including all aspects of the multi-disciplinary team (physicians, consults, supportive care services, etc. and accompanies patients as needed to appointments. Ensures that medication adherence issues are addressed.
• Works with AHN physician offices/facilities to identify at-risk patients and assists in facilitating appropriate screening processes.
• Trends data and outcomes as established for the navigation program. Identifies gaps to improve patient care across the continuum.
• Develops or attends an existing clinical care conference to report out on active patients to the multidisciplinary team.
• May identify bereavement needs of families and develop plan of care.
• Performs other duties as assigned or required.
  
  

Qualifications

Minimum

• Registered Nurse required.
• 1-3 year(s) nursing experience in the specialty required.
• CPR – American Heart Association
• Act 34 Criminal Background Clearance Certificate
• Act 33 Child Abuse Clearance Certificate
• Act 73 FBI Fingerprinting Criminal Background Clearance Certificate
  
  

Preferred

• Bachelor's Degree in Nursing
• Certification in area of expertise.
• Valid PA driver's license may be required.
• Older Adults Protective Services Act (OAPSA) clearance may be required depending on location.
  
  

Disclaimer The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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