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Company: LifeBridge Health
Location: Baltimore
Posted on: November 26, 2022

Job Description:

POSITION SUMMARY: Following a collaborative team model, the Nurse Navigator identifies and manages high risk patient populations, coordinates their care, and provides safe, age appropriate patient care. The RN provides patient care as needed to the population served. *This is a Part-Time position that will be scheduled onsite Wednesday - Friday 8:00am - 4:30pm.* Essential Functions: Population Management: Identifies high risk patients and provides proactive outreach and follow up care while working as a collaborative team with the physicians and all care team members. In conjunction with provider team, identifies patients at risk for poor outcomes. Provides proactive outreach, including telephone, and face to face interaction in the clinical setting. Aids patient and families with coordination of care, including, follow up appointments, scans, and other testing ordered by provider team Other duties as assigned Care Review and Planning: In collaboration with physicians, nurse practitioner, and other members of the treatment team, develop individualized care plans for patients, specific to their needs. Provide comprehensive medical care for complex patients. Complete a structured assessment of medical, bio-psychosocial support and self-management support needs Works collaboratively with provider team and other staff in the practice to develop plan of care by identifying goals and targeting interventions for success of goals Participates in team meeting council and discussions regarding patient care and practice issues Develops professional relationships that facilitate patient/family coping Other duties as assigned Provides follow-up to monitor patient compliance and self-management. Functions as a facilitator of communication between provider and patient/family. (lab results, changes to plan of care, etc.). Clinical Care Management: Work with the physician team to develop individual care plans for patients receiving complex medical care and ensure all standard observations are being met. Review chemotherapy treatment protocols and plan ahead for necessary upcoming imaging studies, consultations and laboratory evaluations. Coordinate ordering, by MD and communicating need for authorization requirements with the physician and financial coordinator assigned to patient. Maintain a database for annual studies and labs required for patients with chronic diseases and communicate with the clinical treatment team when a necessary evaluation is due. Follow up on completed studies and facilitate necessary follow-up communication between the physician and patient/family or other members of the care team for normal results. Assesses patient/family ability to interpret the plan of care and adapts to ensure their understanding. Contributes to unit initiative for improvement in customer satisfaction scores. Maintains safe/caring environment for patient/families/staff. Maintains awareness of cultural differences and delivers care in a nonjudgmental and nondiscriminatory manner. Assumes active role in keeping informed of changes in hospital policy/procedure/equipment. Other duties as assigned Medication refill requests. Work with families and teach how to schedule scans, transportation, etc. All other duties as assigned. Care Coordination: Facilitate communication between the primary treatment team, family, and other members of the treatment team. Ensure seamless patient care. Tasks: Maintain open communication with nursing staff, financial coordinator, and physicians about upcoming authorization for required studies and labs. Assist patients/families in scheduling appointments and communicate changes to their anticipated schedule. Documents care coordination and communicates to team to ensure awareness and patient safety follow thru via patient communicates. Coordinate care among physicians who are collaborating in the care of patients. Share documentation with other physician or treatment teams and provide follow up communications with referring physicians. Function as a system navigator and point-of-contact for patients or families who have questions for their treatment team. Communicate these questions to the treating physician and work together to answer those questions and reliably relay the info back to the patient. Facilitator of Learning: Active member of the patient treatment team by providing education and anticipatory guidance to patients with chronic diseases and new diagnosis with guidance from physician team. Works with the patient/family to ensure compliance with medications/appointments to ensure their understanding and compliance. Teach patients about transitioning care and teach ways for ownership of their care. Integrates patient and family education throughout the delivery of care. Helps patients/families learn what they need to successfully care for themselves and transition within the healthcare environment. Attends family meetings.For all new oncology diagnosis: meets with patient/family to discuss COG binder. Completes bedside teaching, including and not limited to : disease process, medications, medication calendars. Assess and document learning needs of patients/families, discuss with provider team Helps patients/families understand the outlined treatment plan and why to anticipate during visits. Maintains annual competencies. Identifies personal goals and seeks opportunities to pursue professional growth. System Development: Develops process improvement plans and education for healthcare team that directly impacts patient outcomes Tasks: Develop quality improvement plans for chronic care patients Clinical Office Function: Provides clinical office support to providers Tasks: Reviews, with provider, and triage normal lab results. Reviews and triage clinical phone messages for providers Help manage prescription refill requests for providers and patients All other duties as assigned QUALIFICATIONS & REQUIREMENTS: Bachelor of Science in Nursing (BSN) required
3-5 years of experience
Maryland Registered Nurse License (RN)
American Heart Association CPR Certification (BLS)
PALS/ACLS preferred
APHON certification obtained within six months of hire Location: LifeBridge Health ยท PEDS HEMOC/ONC FPP
Schedule: Part-time, Day shift

Keywords: LifeBridge Health, Baltimore , NURSE NAVIGATOR - PEDIATRIC HEMATOLOGY/ONCOLOGY, Healthcare , Baltimore, Maryland

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