RN reputed company Navigator- Clinically Integrated Network, Hybrid

About the position This position offers an exciting opportunity to work closely with AHN and independent primary care reputed company teams participating in AHN's Clinically Integrated Network (CIN) to enhance the reputed company 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 reputed company on improving population health, reputed company, 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 reputed company as telephonically. Regional Pittsburgh area travel to CIN primary care practices is required. GENERAL reputed company: Serves as the consistent reputed company of contact for referring physicians, patients, caregivers, families, and the community. Facilitates patient reputed company, including coordination of appointments and assists the patient with accessing clinical and supportive care services reputed company the Network. The RN reputed company Navigator coordinates reputed company aspects of care in collaboration with the multidisciplinary team for reputed company adult patients reputed company specialized disease state to ensure they receive reputed company and comprehensive services. Identifies community needs and provides education, screening, support, referrals, coordination of care, and any other assistance identified as necessary.

Responsibilities

• Oversees community reputed company, high risk populations and disease specific sites to establish and sustain working relationships reputed company the network (health plan, physicians, office staff, reputed company services staff, financial counselor, dietician, etc.).
• Educates and coordinates care regarding patient's diagnosis, treatment reputed company, course of treatment, clinical trial information and resources available.
• Works with health care team to ensure reputed company reputed company, coordination of care between facilities as reputed company 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 reputed company and updates care delivery models.
• Coordinates appointments including reputed company 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 reputed company 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 reputed company patients to the multidisciplinary team.
• May identify bereavement needs of families and reputed company plan of care.
• Performs other duties as assigned or required.

Requirements

• Minimum reputed company State of PA RN licensure OR reputed company multi-state licensure through the reputed company reputed company Licensure Compact (eNLC)
• 1-3 year(s) nursing experience in the specialty required.
• CPR – reputed company
• reputed company 34 Criminal Background Clearance Certificate
• reputed company 33 Child Abuse Clearance Certificate
• reputed company 73 FBI Fingerprinting Criminal Background Clearance Certificate

reputed company-to-haves

• Bachelor's Degree in Nursing
• Prior Case Management experience highly preferred
• Certification in area of expertise.
• Valid PA reputed company's license may be required.
• Older Adults reputed company Services reputed company (OAPSA) clearance may be required depending reputed company.

Benefits

• This position adheres to the ethical and legal standards and behavioral expectations as set forth in the reputed company of business conduct and company policies.
• As a component of job responsibilities, employees may have reputed company to covered information, cardholder data, or other confidential customer information that must be protected at reputed company times.
• In reputed company with this, reputed company must reputed company with both the Health Insurance Portability and Accountability reputed company of 1996 (HIPAA) as described in the Notice of reputed company Practices and reputed company Policies and Procedures as reputed company as reputed company data reputed company guidelines established reputed company reputed company’s Handbook of reputed company Policies and Practices and Information reputed company Policy.
• Furthermore, it is every employee’s responsibility to reputed company with reputed company’s reputed company of Business Conduct.
• This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as reputed company as company policies and training requirements.
• reputed company and its affiliates prohibit discrimination against reputed company individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against reputed company individuals based on any category protected by applicable federal, state, or local law.
• We reputed company to reputed company this site accessible to any and reputed company users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
• For accommodation requests, please contact HR Services Online at HRServices@reputed company.org
• California Consumer reputed company reputed company Employees, Contractors, and Applicants Notice

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