Clinical Care Navigator bei [Unknown]

JOB SUMMARY

Responsible for the clinical management and scheduling of services for an assigned group of patients. Responsible for providing/performing patient related nursing services.

REQUIREMENTS

1. Education:
   1. Graduate of an accredited nursing program. 
   2. Bachelor of Science in Nursing preferred.
   3. A registered nurse licensed, currently registered in state working in and in good standing with the Board of Nursing.

2. Experience:
   1. A minimum 5 years of experience in home care or home infusion therapy with management experience. 
   2. Knowledge of ACHC and URAC standards and accreditation process.
   3. Knowledge of regulatory requirements for home care New York and New Jersey.
   4. Good communication skills, detail oriented and organized.

3. Fulltime  or Part-Time Employment:
   1. Fulltime-40hrs per week. Work week is Monday thru Friday
   2. Part-Time-29hrs or less Work week is Monday thru Friday
   3. Schedule determined by supervisor.

RESPONSIBILITIES

Clinical Care Navigation

1. Coordinate all patient care services for an assigned group of patients with other members of the health care team.
2. Obtain referral information for new patient referrals and enter the referral into Specialty Pharmacy Business Operating System systems. Review referrals for completeness. 
3. Process referrals to case management for insurance verification.
4. Coordinate patient discharge/start of care with referral source/discharge planner.
5. Obtain initial orders/prescription for care.   Complete the plan of treatment at the start of care and update as care needs change or every six months.
6. Complete initial telephonic assessment with the patient to determine medical needs, functional limitations and willingness to participate in care.
7. Develop the patient’s initial supply list based on the patient’s individualized care needs.
8. Maintain accurate and complete information in the Specialty Pharmacy Business Operating System systems for assigned group of patients including, but not limited to: demographic information, medical information (height and weight, diabetes status, past medical history), nursing care provider, contact persons.
9. Provide clinical support to the patient, field staff and pharmacy staff.
10. Based on the initial telephonic assessment and in conjunction with pharmacy, determine the appropriate administration method for prescribed therapy.
11. Participate in daily patient care rounds to discuss pending referrals, current patients and clinical issues.
12. Review nursing documentation to assure accurate and thorough information.
13. Track nursing visits by patient and obtain authorization for additional visits through case management.
14. Participate in the company’s after hours on call system as needed.
15. Participate in the company’s Quality Assurance Program.
16. Audit patient medical records for assigned group of patients to assure complete and accurate documentation.
17. Participate in daily patient care rounds to coordinate patient services between nursing, pharmacy and reimbursement.
18. Performs skilled nursing visits to all ages of patients as needed.

Operational (Where required)

1. Acts as the Alternate Nursing Supervisor where required. Responsible for overseeing the operations and management of the local Home Health Agency in the absence of the Regional Nurse Manager/Administrator.
2. Is available to the agency, either in person or by telecommunication in the absence of the Regional Nurse Manager/Administrator.
3. Any other responsibility as designated by the employee’s supervisor.