RN Patient Navigator, Utilization Review - Full Time

Mercy-Health-System-Corporation; Rockford (IL); Hybrid; USD 114,616,000 - 172,200,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Life & Disability Insurance

FSA/HSA Options

Paid time off

Tuition reimbursement

Job summary

Mercyhealth is seeking an RN Patient Navigator to coordinate patient care and ensure timely discharge planning across hospital settings in northern Illinois and southern Wisconsin. You will conduct early assessments, create individualized care plans, arrange post-hospital services, educate patients and families, and collaborate with the care team to meet core measures while minimizing readmissions.

The position requires a BSN or enrollment in a BSN program, and an active RN license in IL/WI;

Qualifications

• Graduate of an accredited nursing program.
• BSN or enrollment in BSN Completion Program.
• Current RN license in IL/WI or eligibility.

Responsibilities

• Coordinate case management, advocacy, and care coordination to ensure seamless transitions.
• Conduct early patient assessment to identify discharge planning needs.
• Create individualized care plans meeting continuing care needs.
• Refer to post-hospital providers using community resources.
• Educate patients and families about chronic disease management.
• Collaborate with nursing and physician staff to meet core measures before discharge.
• Identify and intervene in financial risk to the patient and organization.

Skills

Allscripts Care Management

Epic EMR

Microsoft Outlook

Excel

Word

On-call readiness

Education

BSN or enrollment in BSN Completion Program

Tools

Allscripts Care Management

Epic EMR

Microsoft Outlook

Excel

Word

Job description

OVERVIEWThe RN Patient Navigator coordinates and facilitates patient care activities to assure appropriateness of services and efficient utilization of resources, improve coordination of care across the health care continuum, and to contribute to improved patient satisfaction and outcomesSchedule: 40 hours/week - Potential hybrid schedule after initial trainingShift: DaysESSENTIAL DUTIES AND RESPONSIBILITIESProvides case management, advocacy, and care coordination services to hospital patients in a variety of settings to assure seamless transitions in care while minimizing any associated delays or risk of readmission.Conducts early patient assessment, by case-finding and referral, to identify coordination and discharge planning needs.Creates individualized, patient -focused plan for meeting continuing care needs.Makes referrals to post-hospital care providers utilizing knowledge of community resources.Collaborates with the healthcare team to ensure discharge is timely, patient education and instructions are complete, and appropriate follow-up is established.Utilizes current clinical nursing knowledge to effectively educate patients and families about chronic disease conditions.Collaborates with staff nurses and physicians to ensure all elements for core measures have been met prior to discharge.Conducts clinical review process according to Utilization Management Plan.Identifies and intervenes in situations that pose financial risk to the patient and the organization.EDUCATION AND/OR EXPERIENCEGraduate of an accredited nursing program.- BSN or upon hire BSN completion agreement for enrollment in an accredited BSN Completion ProgramMay require specific years of applicable experience to qualify (per department guidelines).CERTIFICATION/LICENSURECurrent Registered Nurse License in the state of practice.- Dual Licensure (Wisconsin and Illinois) PreferredCase Management Certification (ACM) preferred.Certification preferred within three years to a specialty approved by CNO or designee; i.e.; Case Management, Med/Surg or Diabetic Education.BLS/CPR required within 90 daysOTHER SKILLS AND ABILITIESMay include color blind test (per department guidelines)Must be skilled with use of voice mail and phone features. Must be able to use available technology for language interpretation.Must have expert knowledge of Allscripts Care Management program and Epic EMR. Must be able to use Microsoft Outlook, and have basic knowledge of Excel and Word. Must be able to easily toggle between computer applications.Must be available to work and or be on-call on weekends and holidays, as assigned. On-call requires accessibility by pager or cell phone during assigned hours and ability to respond promptly to pages by phone.LEVEL OF SUPERVISIONAssignments are based on abilities and are normally received in the form of results expected and due dates. Only general procedures are available to guide work. Must be able to work independently with minimal guidance.SUPERVISESThis job has no supervisory responsibilities.PAY RANGE:$38.80 - $60.14Mercyhealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status.Mercyhealth offers competitive pay and a comprehensive benefits package including:Medical, Dental, VisionLife & Disability InsuranceFSA/HSA OptionsGenerous, accruing paid time offPaid Parental and caregiver leaveCareer advancement and educational opportunitiesTuition and certification reimbursementCertification ReimbursementWell-being ProgramsEmployee DiscountsOn-Demand PayFinancial EducationAnnual recognition/awards eventsPartner appreciation daysFamily entertainment/attractions discountCommunity service/improvement opportunitiesClick here for more details regarding Mercyhealth Careers Benefit Information.At Mercyhealth, we don’t simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin.Mercyhealth has been nationally recognized for our commitment to our people and culture, including:#1 in the nation on AARP's Best Employers for Workers Over 50One of Working Mother magazine's 100 Best Companies for Working MothersA Top 50 Company and Top 10 Nonprofit for Executive Women