RN NAVIGATOR-CARE COORD (28771)
UnityPoint Health - Waterloo, IA

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The RN Care Coordination Navigator (CCN) will take professional ownership and accountability to lead patient safety/quality/medically necessary care through leadership in case management, utilization, best practice coaching, and discharge process.

The CCN is focused on providing the patient and the physicians with highly supported patient access determination, patient care coordination inclusive of emergency department (ED) U-Turn opportunities with community care, patient observation status, patient admission status, ED U-Turn discharge planning and discharge process that begins within the ED environment inclusive of patient access status determination within the ED through collegial collaboration, mentoring, and coaching with the ED and Hospitalist Providers (Physicians and Midlevels).

The CCN will provide supportive collaboration with community services such as the Primary Care Provider (Physician/ Midlevel), Home Care, Palliative Care, Inpatient Rehab, SNF, LTC, Hospice, and other key community resources through care coordination leadership on behalf of ideal care for our patients with the goal of providing medically necessary care in the appropriate level of care.

The CCN is responsible for engaging in creating a culture of multidisciplinary innovation, learning, teamwork and professional practice, consistent with the mission, vision and values of Allen Health Systems.

The CCN will establish effective mechanisms of communication with Patients, patient families/significant others, Providers (Physicians/Midlevels), staff, and the management team to foster an environment of openness, trust, team work and staff development focused on ideal patient-centric care.

The CCN will communicate with department team regularly to review service issues and opportunities for improvement to ensure the delivery of high quality service to all internal and external customers. Primary responsibility toward Adaptive Design root cause analysis (A3) and counter measure action plan execution for patient readmissions within 30 day post-acute hospital discharge period.

The CCN will assist with performance evaluations, coaching, counseling and disciplinary action as directed.

As applicable, the CCN will identify signaled department care coordination high risk / department trended events, conduct ongoing reviews, including but not limited to quarterly quality chart audits, PI and updating of clinical practices, processes and documentation of care produced to assure compliance with service standards, regulatory requirements and accreditation standards associated with care coordination (patient access status, patient quality of care/safety regarding best practice, readmissions, Medical Necessity of care, Utilization, continuum of care process, and discharge process).

The CCN is responsible for completion of communication tasks and activities in a timely manner. This would include, but is not limited to: responding to email, voicemail or telephone messages, promptly, accurately, and professionally; attend staff meetings / committee meetings as scheduled; direct communication and inquiry, as needed to navigate ideal patient care, with patients, family members and significant others, Physicians, Midlevels, PCPs, ancillary health care team members, and community partners / referral sources.

The CCN will demonstrate collegial, professional, and collaborate relationship building with patients, family members and significant others, Physicians, Midlevels, PCPs, ancillary health care team members, community partners / referral sources, and other key individuals and entities to navigate ideal patient ED, hospitalization, and discharge process.

As applicable, the CCN will perform comprehensive psychosocial assessment and applicable navigational follow up.

As applicable to patient disease process, the CCN will actively initiate and engage in Zone(s) Education with patient, family members and significant others within the ED environment.

As applicable, the CCN will provide information and referral services regarding abuse, depression, financial, environmental, and alternate holistic patient care needs.

The CCN will collaborate and consult with the patient, family members/significant others, Providers, PCPs, and ancillary health care team members to become a multidisciplinary health care team whose goal is to provide continued care across the health care continuum.

The CCN will assist patient, family members and significant others in goal setting related to observation, admission, discharge status and as applicable selecting discharge plans consistent with identified needs and assist in development of patient, family members and significant others education materials around those goals and needs as applicable to the ED environment.

The CCN will plan and arrange the patients’ post-ED care aligned with the patient’s qualifiable and agreed upon post ED care environment such as but not limited to: follow up PCP / outpatient care, observation status, inpatient admission status, U-turn opportunities: home with self/family care, home with home care, home with palliative care, home with hospice care, facility based care (inpatient rehab care, SNF care, Nursing home care, and or alternate entity). The care coordination planning will begin when patient status deemed to require patient access status (observation / admission), evolve over the ED episode, and occur in a timely manner with the patient, family members and or significant others engagement, awareness, and agreement. Patient access status to be identified and communicated to the patient, patient family and or significant others while in the ED environment to provide a proactive communication of status inclusive of patient financial responsibility, and alternate care opportunities with U-turn and community care services (PCP, outpatient follow up, home care, Palliative care, Hospice, and other key community partners collaborative support).

As applicable, the CCN will be highly competent in InterQual and EHR processes as well as an organizational expert in patient status qualification to ensure appropriate patient access or continued stay status regarding inpatient, observation, and discharge status. The CCN will have a primary responsibility to determine the patients’ status while in the ED environment. Applicable patients entering the hospital during the interim period of ED Care Coordination Navigator coverage will be reviewed for patient access status by the CCN upon the beginning of the next scheduled shift. (ie. Applicable patient enters hospital at 0200 and placed on 3 Medical, CCN based in ED will perform patient’s InterQual (EHR if applicable) patient access status at the beginning of the next scheduled shift typically at 0800). All appropriate documentation with the Electronic Health Record, AuthCert work queue, event manager, accountDoc, or alternate system as applicable to case.

The CCN will perform, as applicable to any prolonged ED episodes, any admission assessment, screening for appropriateness, continued stay reviews according to established criteria of third party carriers, and as found necessary on cases with third party payor review (using InterQual).

As applicable the CCN will obtain authorization or precertification for all third party payors.

The CCN will engage in and assist in oversight of the organization's Utilization Management Plan, including responsibility for managing admission on all behavioral health patients, and continued stay reviews for appropriate utilization of hospital resources and quality of services provided.

The CCN will support ED social workers with established priority process for MHU Bed placement for all medically stable suicide precaution patients in hold in ED environment awaiting MHU bed placement in any Iowa MHU facility to avoid any ICU or med-surg hold placement.

The CCN will ensure medical necessity of care is followed recognizing the impact of providing non-medically necessary care on cost per case (CPC).

The CCN ensures access status, observation placement, admission placement, and ED U-turn process discharge planning is implemented in a timely manner and ensures that all disciplines are providing appropriate interventions. Documents appropriate plans and concurrent status of plans in pre-established format with identified goals according to departmental policy within the Electronic Health Record.

The CCN will identify, signal, and collect appropriate trends on patterns of care: risk for acute re-hospitalization, possible avoidable days, discharge delays, variances from critical paths, and resource utilization.

The CCN maximizes positive financial outcomes for patients and hospital by conducting ongoing chart review to monitor appropriateness of treatment, resource utilization, quality of care. Applies criteria, performs concurrent reviews. Works with physicians regarding utilization issues and concurrent denials as needed.

The CCN will achieve course work certification in Integrated Chronic Care Disease Management as assigned however not to exceed 2 years from position hire. Completion includes completing the Integrated Chronic Care Disease Management formal training session, successfully completing computer based-learning modules and a competency evaluation. Use the Integrated Chronic Care Disease Management philosophy, skills, tools and documentation requirements in clinical practice. Satisfactory achieve acceptable level performance review annually. The CCN may request coverage of Certification expense through Human Resource benefits / policy as applicable to status.

The CCN will perform other duties as requested by Director to facilitate the smooth and effective operations of the organization.

The CCN will maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, and participating in professional societies. Complete integrated Chronic Care Disease Management (ICCDM) Certification process as assigned however no later than 2 years from date of hire to position.

The CCN will behave in a manner consistent with Allen Health System Mission, Vision, Values, and Expectations for Excellence.

The CCN will maintain compliance with OSHA, Accreditation Standards and Risk Management guidelines.

The CCN will maintain compliance with Personnel policies and procedures.

The CCN will behave in a manner consistent with all Corporate Compliance policies and procedures.

The CCN will have regular and predictable attendance which is required for this position to meet patient care needs.

Qualifications

A. Current license in the state of Iowa or meets criteria established by Iowa Board of Nursing.

B. Certification in specialty preferred; commitment to obtain within 2 years of hire date.

C. BSN required or actively enrolled in BSN completion program. MSN preferred.

D. 3 years recent experience in direct patient care involving specialty.

E. Team leadership skills and excellent communication skills.

F. Able to meet the physicians' demands on file in the Human Resources Department.

To be considered for this position you must complete an online application for this position

AND

you must click on the following link:
http://www.starthsi.com/survey/rlogin.php?token=be91a1728c4f38bcd1b5f6c92e44c02a

to complete an assessment tool.

Internal Applicants do not need to take the survey.
Job Information

RN NAVIGATOR-CARE COORD

(28771)

Company:
ALLEN MEMORIAL HOSPITAL CORP

Facility / Division:
ALLEN MEMORIAL HOSPITAL CORP

Account:
NO SERVICE LINE

Department:
CASE MANAGEMENT

Employment Status:
FULL-TIME REGULAR (FTR)

FTE:
Full-Time (FTE: 0.80, Hours: 64)

Shift:
Primarily Days, with every third weekend and holiday

Salary Range:
$ 25.25 - $ 37.50

Location:
ALLEN MEMORIAL HOSPITAL

1825 LOGAN AVENUE

WATERLOO, IA 50703

Essential Functions & Responsibilities

The RN Care Coordination Navigator (CCN) will take professional ownership and accountability to lead patient safety/quality/medically necessary care through leadership in case management, utilization, best practice coaching, and discharge process.

The CCN is focused on providing the patient and the physicians with highly supported patient access determination, patient care coordination inclusive of emergency department (ED) U-Turn opportunities with community care, patient observation status, patient admission status, ED U-Turn discharge planning and discharge process that begins within the ED environment inclusive of patient access status determination within the ED through collegial collaboration, mentoring, and coaching with the ED and Hospitalist Providers (Physicians and Midlevels).

The CCN will provide supportive collaboration with community services such as the Primary Care Provider (Physician/ Midlevel), Home Care, Palliative Care, Inpatient Rehab, SNF, LTC, Hospice, and other key community resources through care coordination leadership on behalf of ideal care for our patients with the goal of providing medically necessary care in the appropriate level of care.

The CCN is responsible for engaging in creating a culture of multidisciplinary innovation, learning, teamwork and professional practice, consistent with the mission, vision and values of Allen Health Systems.

The CCN will establish effective mechanisms of communication with Patients, patient families/significant others, Providers (Physicians/Midlevels), staff, and the management team to foster an environment of openness, trust, team work and staff development focused on ideal patient-centric care.

The CCN will communicate with department team regularly to review service issues and opportunities for improvement to ensure the delivery of high quality service to all internal and external customers. Primary responsibility toward Adaptive Design root cause analysis (A3) and counter measure action plan execution for patient readmissions within 30 day post-acute hospital discharge period.

The CCN will assist with performance evaluations, coaching, counseling and disciplinary action as directed.

As applicable, the CCN will identify signaled department care coordination high risk / department trended events, conduct ongoing reviews, including but not limited to quarterly quality chart audits, PI and updating of clinical practices, processes and documentation of care produced to assure compliance with service standards, regulatory requirements and accreditation standards associated with care coordination (patient access status, patient quality of care/safety regarding best practice, readmissions, Medical Necessity of care, Utilization, continuum of care process, and discharge process).

The CCN is responsible for completion of communication tasks and activities in a timely manner. This would include, but is not limited to: responding to email, voicemail or telephone messages, promptly, accurately, and professionally; attend staff meetings / committee meetings as scheduled; direct communication and inquiry, as needed to navigate ideal patient care, with patients, family members and significant others, Physicians, Midlevels, PCPs, ancillary health care team members, and community partners / referral sources.

The CCN will demonstrate collegial, professional, and collaborate relationship building with patients, family members and significant others, Physicians, Midlevels, PCPs, ancillary health care team members, community partners / referral sources, and other key individuals and entities to navigate ideal patient ED, hospitalization, and discharge process.

As applicable, the CCN will perform comprehensive psychosocial assessment and applicable navigational follow up.

As applicable to patient disease process, the CCN will actively initiate and engage in Zone(s) Education with patient, family members and significant others within the ED environment.

As applicable, the CCN will provide information and referral services regarding abuse, depression, financial, environmental, and alternate holistic patient care needs.

The CCN will collaborate and consult with the patient, family members/significant others, Providers, PCPs, and ancillary health care team members to become a multidisciplinary health care team whose goal is to provide continued care across the health care continuum.

The CCN will assist patient, family members and significant others in goal setting related to observation, admission, discharge status and as applicable selecting discharge plans consistent with identified needs and assist in development of patient, family members and significant others education materials around those goals and needs as applicable to the ED environment.

The CCN will plan and arrange the patients’ post-ED care aligned with the patient’s qualifiable and agreed upon post ED care environment such as but not limited to: follow up PCP / outpatient care, observation status, inpatient admission status, U-turn opportunities: home with self/family care, home with home care, home with palliative care, home with hospice care, facility based care (inpatient rehab care, SNF care, Nursing home care, and or alternate entity). The care coordination planning will begin when patient status deemed to require patient access status (observation / admission), evolve over the ED episode, and occur in a timely manner with the patient, family members and or significant others engagement, awareness, and agreement. Patient access status to be identified and communicated to the patient, patient family and or significant others while in the ED environment to provide a proactive communication of status inclusive of patient financial responsibility, and alternate care opportunities with U-turn and community care services (PCP, outpatient follow up, home care, Palliative care, Hospice, and other key community partners collaborative support).

As applicable, the CCN will be highly competent in InterQual and EHR processes as well as an organizational expert in patient status qualification to ensure appropriate patient access or continued stay status regarding inpatient, observation, and discharge status. The CCN will have a primary responsibility to determine the patients’ status while in the ED environment. Applicable patients entering the hospital during the interim period of ED Care Coordination Navigator coverage will be reviewed for patient access status by the CCN upon the beginning of the next scheduled shift. (ie. Applicable patient enters hospital at 0200 and placed on 3 Medical, CCN based in ED will perform patient’s InterQual (EHR if applicable) patient access status at the beginning of the next scheduled shift typically at 0800). All appropriate documentation with the Electronic Health Record, AuthCert work queue, event manager, accountDoc, or alternate system as applicable to case.

The CCN will perform, as applicable to any prolonged ED episodes, any admission assessment, screening for appropriateness, continued stay reviews according to established criteria of third party carriers, and as found necessary on cases with third party payor review (using InterQual).

As applicable the CCN will obtain authorization or precertification for all third party payors.

The CCN will engage in and assist in oversight of the organization's Utilization Management Plan, including responsibility for managing admission on all behavioral health patients, and continued stay reviews for appropriate utilization of hospital resources and quality of services provided.

The CCN will support ED social workers with established priority process for MHU Bed placement for all medically stable suicide precaution patients in hold in ED environment awaiting MHU bed placement in any Iowa MHU facility to avoid any ICU or med-surg hold placement.

The CCN will ensure medical necessity of care is followed recognizing the impact of providing non-medically necessary care on cost per case (CPC).

The CCN ensures access status, observation placement, admission placement, and ED U-turn process discharge planning is implemented in a timely manner and ensures that all disciplines are providing appropriate interventions. Documents appropriate plans and concurrent status of plans in pre-established format with identified goals according to departmental policy within the Electronic Health Record.

The CCN will identify, signal, and collect appropriate trends on patterns of care: risk for acute re-hospitalization, possible avoidable days, discharge delays, variances from critical paths, and resource utilization.

The CCN maximizes positive financial outcomes for patients and hospital by conducting ongoing chart review to monitor appropriateness of treatment, resource utilization, quality of care. Applies criteria, performs concurrent reviews. Works with physicians regarding utilization issues and concurrent denials as needed.

The CCN will achieve course work certification in Integrated Chronic Care Disease Management as assigned however not to exceed 2 years from position hire. Completion includes completing the Integrated Chronic Care Disease Management formal training session, successfully completing computer based-learning modules and a competency evaluation. Use the Integrated Chronic Care Disease Management philosophy, skills, tools and documentation requirements in clinical practice. Satisfactory achieve acceptable level performance review annually. The CCN may request coverage of Certification expense through Human Resource benefits / policy as applicable to status.

The CCN will perform other duties as requested by Director to facilitate the smooth and effective operations of the organization.

The CCN will maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, and participating in professional societies. Complete integrated Chronic Care Disease Management (ICCDM) Certification process as assigned however no later than 2 years from date of hire to position.

The CCN will behave in a manner consistent with Allen Health System Mission, Vision, Values, and Expectations for Excellence.

The CCN will maintain compliance with OSHA, Accreditation Standards and Risk Management guidelines.

The CCN will maintain compliance with Personnel policies and procedures.

The CCN will behave in a manner consistent with all Corporate Compliance policies and procedures.

The CCN will have regular and predictable attendance which is required for this position to meet patient care needs.

Qualifications

A. Current license in the state of Iowa or meets criteria established by Iowa Board of Nursing.

B. Certification in specialty preferred; commitment to obtain within 2 years of hire date.

C. BSN required or actively enrolled in BSN completion program. MSN preferred.

D. 3 years recent experience in direct patient care involving specialty.

E. Team leadership skills and excellent communication skills.

F. Able to meet the physicians' demands on file in the Human Resources Department.

To be considered for this position you must complete an online application for this position

AND

you must click on the following link:
http://www.starthsi.com/survey/rlogin.php?token=be91a1728c4f38bcd1b5f6c92e44c02a

to complete an assessment tool.

Internal Applicants do not need to take the survey.

UnityPoint Health - 14 months ago - save job - block