Care Navigator RN - Nurse Navigator

Company: Evanston Hospital
Location: Evanston
Posted on: March 13, 2023

Job Description:

Care Navigator RNPosition Highlights:

* Position: Care Navigator RN - NPA Administration
* Location: 1001 University Place, Evanston, IL
* Full Time/Part Time: Full-Time (40 hrs/wk)
* Hours: Monday-Friday 8:00AM - 4:30PM. Rotating weekends and rotating hours may be required.
* Required Travel: Will need to travel to physicians offices and patients homes as needed.

What you will need:

* License: Current professional Nursing Licensure in the state of IL required
* Education: Bachelor's degree required. Bachelor's degree in Nursing from an NLN accredited school of nursing required; BSN strongly preferred
* Certification: Basic Life Support for Healthcare Providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross). Clinical certification, such as case management certification, is beneficial
* Experience: 2 years of clinical nursing experience preferred. Minimum of 2 years of utilization review, discharge planning, case management or disease management preferred. Nursing experience in home services, ambulatory services working with high-risk patients beneficial. Experience with Microsoft Office Suite. Experience with Electronic Medical Record (EMR) platform preferred
* Skills: Able to communicate and work collaboratively with a range of stakeholders and team members; Knowledge of community resources.

What you will do:

* Will work in Ambulatory Care Management roles to provide care coordination to Health Plan beneficiaries
* Will service Aetna, Cigna, BCBS, ACO, BCBS MMAI contracts to fulfill contractual obligations to perform care managment functions including ED follow up phone calls, post discharge phone calls, complex care management and disease state management
* Connect with patient at the time of diagnosis (either ED or pre-admission) and follow the patient across the hospital stay and 90 days post discharge
* Guide the patient and family through the health system from diagnosis, testing, treatment and follow-up care to assist patient with navigating the continuum of care. Eliminate barriers to patient's access to health care services and facilitates continuity of care/care coordination
* Partner with the healthcare team to ensure clinical decision-making, implementation of recommendations, and discharge planning are timely and appropriate. Oversee and facilitates effective and impactful interdisciplinary rounds that are structured and standardized
* Facilitate payor authorization processes and ensure that the patient type assigned is accurate
* Work with the CDI team to ensure that documentation accurately reflects severity of illness and intensity of service
* Perform daily coordination between multiple departments, multi-disciplinary team, medical clinics, and community outreach to gain knowledge of patient, assure patient safety, smooth transitions of care, and manage utilization and total cost of care
* Act as advisor/educator by partnering with social work in providing emotional support including goals of care and counseling
* Available to his/her assigned patient population 24/7 and participates as part of a call coverage structure
* Other duties - as this job evolves, this role will complete other duties assigned

NorthShore University HealthSystem (NorthShore) is an integrated healthcare delivery system consistently ranked as a Top 15 Teaching Hospital in the U.S. The NorthShore system, headquartered in Evanston, Ill., includes five hospitals - Evanston, Glenbrook, Highland Park, Skokie and Swedish. NorthShore also includes a 900 physician multispecialty group practice, NorthShore Medical Group, with more than 140 locations in the Chicagoland area. NorthShore has an established reputation and employs over 10,500 people.

NorthShore is committed to excellence in its academic mission and supports teaching and research as the principal teaching affiliate of the University of Chicago Pritzker School of Medicine.

NorthShore was the first health system in Illinois to achieve Magnet-- recognition-the highest, most prestigious honor that demonstrates excellence in nursing and high standards in patient care-something only achieved by 6% of hospitals nationwide. The system earned Magnet re-designation in 2019. When you work for NorthShore, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Please explore our website (www.northshore.org) to better understand how NorthShore delivers on its mission "to preserve and improve human life" through superior clinical care, academic excellence and innovative research.

NorthShore is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.

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Keywords: Evanston Hospital, Evanston , Care Navigator RN - Nurse Navigator, Healthcare , Evanston, Illinois