RN, Registered Nurse Patient Navigator Senior - Tyler Specialty Heart Fail Clinic Job at CHRISTUS Health, Texas

VDZ2ZjcxRkErZTR2cUNwWEZtZkw3WUxYRXc9PQ==
  • CHRISTUS Health
  • Texas

Job Description

Description Summary: The Registered Nurse Patient Navigator Lead is a Registered Nurse or licensed Nurse Practitioner who provides health and wellness coaching, case management services, analysis and expertise regarding CHRISTUS services. These services will be provided by monitoring cases and claims, analyzing biometric and health risk assessment data, organizing disease management programs and proactively interacting with members, physicians and other providers. Incumbent oversees integrated data warehouse including program utilization, disease management programs and contracted provider network support. Responsibilities: Oversee the development, implementation and management of an integrated medical benefit program including case management and health/disease management. Establish a system for coordinating the caseload patient's care throughout the continuum of care. Use standard tools, databases and methodologies to support the health benefit program and provide leadership in managing cases, events and diseases that are determined to be targeted priorities by Senior Management of contracted employers. Interact with providers and plan members in case management medical activities to provide the most efficient and effective service. Identify targeted chronic diseases/high risk individuals (with vendor support) and develop programs to reduce the financial and health risks, using internal hospital programs/services whenever possible. Monitor and evaluate the effects of case management on the patient population. Create outcomes-management focus by interdisciplinary analysis of specific clinical, financial and satisfaction elements for the patient population. Assist in the analysis of demographics, utilization and reimbursement. Prepare cost analysis and other reports to determine the reasonableness of claim/cost data and utilization rates. Make recommendations based on data analysis for benefit structure, pharmacy formulary, deductibles, co-pays, out of pocket, etc. to contracted employer groups. Maintain consistent attendance, punctuality and personal appearance in accordance with CHRISTUS attendance and dress code policies. Uphold organizational values by treating others with respect, keeping commitments and working ethically and with integrity. Attend meetings as required and participate in team activities. Exhibit confidence, motivate and inspire others. Establish and maintain effective working relationships with team members, patients and the public by demonstrating the ability to communicate verbally and in writing while responding clearly and effectively. Demonstrate the ability to read and respond to e-mail and appointment requests in a timely manner and on a regular basis. Use time efficiently, plan for additional resources, set goals and objectives and work in an organized manner. Demonstrate safety practices and maintain a safe environment for patients, visitors and fellow team members by following established safety and infection control standards. Requirements: Associate's Degree in Nursing 3 to 5 years of experience RN License in state of employment or compact BLS Work Schedule: 5 Days - 8 Hours Work Type: Full Time

Job Tags

Full time,

Similar Jobs

HCRC Staffing

Physical Therapist Bethel AK Job at HCRC Staffing

 ...for a Physical Therapist who is excited to be in remote Alaska and is willing to invest their skills and...  ...Duties: Patient Consultation-review health and medical histories, exam patients, review pertinent medical records/imaging, and reason for visit Consult with referring... 

Dr. Novikov Wellness and Skin Care

Medical scribe, practice assistant Job at Dr. Novikov Wellness and Skin Care

 ...Job Description Medical Scribe - Gap Year Program Perfect for Pre-Med grads, Aspiring Doctors and Healthcare providers Join Our Leading Gap Year Program Established in 2016 Are you preparing for a career in healthcare and looking for hands-on experience... 

Appen

Search Engine Evaluator Job at Appen

Are you ready for a challenge? Would you like to learn about new places without leaving your home? Don't missthis opportunity to provide relevance and accuracy ratings for one of the world's largest mapping applications! Tasks are dynamic and improve programs...

University of Kansas Health System

Ambulatory - Patient Service Representative - Front Desk - Fulltime Job at University of Kansas Health System

 ...Position Title Ambulatory - Patient Service Representative - Front Desk - Fulltime Bell Hospital, Indian Creek Main Position...  ...consisting of multiple appointments. Responsible for registration of patient during the scheduling process, including entering demographics... 

Payne MGT

Assistant Office Manager/Degreed Accountant Job at Payne MGT

 ...Opportunity: As a result of continued growth, we are seeking a degreed accounting professional who is eager to build a long-term...  ...advancement into an Office Manager role Qualifications: Bachelor's degree in Business Administration (Accounting emphasis preferred...