POSITION SUMMARY

Responsible for providing personalized member face to face visits in the acute care hospital setting to ensure the member is set up for a safe discharge and post discharge care. Educate the members on the benefits that are available to them during and after discharge and support the members with getting these services well-coordinated. Ccollaborate with the hospital-based care team and the health plan care team to ensure the member is enrolled in the appropriate post discharge care management program.

PRIMARY ACCOUNTABILITIES

1. Meet with all members during the in patient (IP) stay.

2. Conduct a high-level risk assessment with the member in conjunction with the Utilization Management (UM) nurse.

3. Ensure the members are introduced to the appropriate post discharge care management program and are enrolled prior to discharge.

4. Consult with internal clinical staff as needed when assessment or gaps in care indicate increasing severity of the member’s condition requiring more intense monitoring and intervention.

5. Promote health management programs and provide community resources available to members.

6. Utilize engagement skills and motivational interviewing techniques to enroll members in programs.

7. Maintain supportive communication with the member via the member’s channel preference (phone, web, e-mail, mail).

8. Provide education, monitor and reporting compliance, identify gaps in care, and adjust the plan as needed. 9. Assist with coordinating post discharge follow up visits timely and that members has a plan in place to get to their appointments.

MINIMUM QUALIFICATIONS Education:

• Education: Associate’s degree in Nursing or Nursing Sciences

• Licensure: Current Florida RN license free of any restrictions or disciplinary action pending and able to practice without the supervision of another licensed legally and independently professional.

• Certification: None required

• Work Experience: Three years clinical experience in Med Surg or critical care.

• Work Experience in lieu of Education: None

• Knowledge/Skills/Abilities

• Proficient in Microsoft Office – Outlook, Word, Excel, PowerPoint
• Ability to work autonomously with minimal supervision
• Strong critical thinking skills o Strong communication skills and professional presence
• Ability to maintain composure in stressful office environment
• Excellent interpersonal skills and ability to connect and build a relationship with the members

PREFERRED QUALIFICATIONS

• Education: Bachelors degree

• Licensure: No additional

• Certification: Certified Case Manager (CCM), or ACM

• Work Experience: Two years previous experience in care management, Utilization Management, Managed Care, and/or Workers Compensation/Disability Medical Management

• Work Experience in lieu of Education: None

• Knowledge/Skills/Abilities: No additional

PHYSICAL REQUIREMENTS

• Majority of time involves sitting or standing; occasional walking, bending, stooping

• Long periods of computer time or at workstation

• Light work that may include lifting or moving objects up to 20 pounds with or without assistance.

• May be exposed to inside environments with varied temperatures, air quality, lighting and/or low to moderate noise

• Communicating with others to exchange information.

• Visual acuity and hand-eye coordination to perform tasks

• Workspace may vary from open to confined; on site or remote

• May require travel to various facilities within and beyond county perimeter; may require use of personal vehicle

Job: *Radiology

Organization: *Health First Medical Group LLC

Title: HFMG RN Nurse Navigator - Breast Center

Location: Florida - Brevard County-Melbourne

Requisition ID: 072791