HCA, Hospital Corporation of America Care Navigator Registered Nurse in Tallahassee, Florida
Florida Care Partners (FCP) is a Florida statewide Clinically Integrated Network (CIN) that holds commercial and Medicare Advantage value-based health plan contracts and supports physician practices with an infrastructure to be successful in these contracts by providing network management services, performance-based data analytics and clinical care workflow resources. FCP is a physician-governed collaborative network committed to helping physicians access value-based contracts and maintain financial stability through the delivery of high quality, coordinated care that addresses unnecessary costs and improves the overall health of patients. * * General Summary of Duties: The Care Navigator is accountable for assuring a high standard of quality and coordination of care, in support of a statewide Clinically Integrated Network (CIN) that holds value-based commercial, Medicare Advantage and direct employer agreements. The Care Navigator has a defined role, working in an advisory capacity to the CIN participation physician practices, creating and monitoring standards of care, and providing support of the CIN value based programs. The Care Navigator supports the CIN care coordination/care management initiatives, which may include physicians, nurses and social workers, in outreaching, triaging and if appropriate providing care navigation for patients attributed to the CIN. * * Duties Include But Not Limited To: * Conduct outbound calls to patients recently discharge from hospital or ER to ensure appropriate follow-up with primary care providers. * Conduct outreach and follow up in regards to patients that are high and medium risk, have a gap score and gaps in care. * Complete a standard assessment for clinical, behavioral and community needs, triage for additional support by licensed clinical staff and complete referrals to additional resources as needed * Provide patient education relative to navigating the health care system and community resources * Collaborate with providers and practice teams to communicate patient’s needs and develop solutions to overcome barriers. * Maintain a case load of patients requiring care navigation support and document as appropriate * Collaborate with the payer systems and payer Care Coordinators on specific patient care needs to include encouraging them to work with their applicable payer Case Manager, Disease Manager or Wellness Program designee. * Supports the efforts of providers and practice teams on office based care delivery interventions resulting in cost of care savings and improved health outcomes for patients. * Test and pilot new VBC initiatives and work with leadership on refining processes, helping the CIN achieve contractual metrics. * Review reports from payers and assist Director of Quality in the interpretation of the reports and actions needed. * Assist in the development, implementation and monitoring of CIN policies and procedures as they relate to value based programs. * When the need arises, will perform other duties as assigned by supervisor. * * Knowledge, Skills and Abilities: This is an office-based or possibly home-based position. Some occasional travel may be required to meet CIN physician practices as part of relationship building and collaboration around patient care coordination. Great communication skills are necessary, particularly on the telephone. Skills that will help success in this role are: * Excellent oral communication skills both in-person and telephonically, to groups and individuals * Flexible, courageous and positive attitude about unexpected changes and fluctuating workloads * Training and presenting * Excellent written communication skills * Time Management * Provider engagement * Population health management * Community health * Case Management * Disease Management * Quality Improvement * Motivational Interviewing and active listening Education/License/Certifications/Qualifications: The requirements for the Care Navigator include, but are not limited to: * Graduate of an accredited school of nursing as a Registered Nurse coupled with 5 years health care experience in primary care, care management/coordination or other related field. Commensurate experience in public health, social services or other health care field may take the place of this requirement. * ICD-10 Coding Certification; if not certified upon hiring, certification will be required approximately within first 6 months after hire * Competence in the ability to triage patients over the phone and in person. * Strong computer skills, particularly related to Microsoft applications Word, Access, Visio, Excel, PowerPoint and Outlook. * Comfort with exploring and learning to use new or unfamiliar applications or databases. * Working knowledge of health information technology. * Managed care understanding specifically regarding value based payer contract requirements. * Commitment to collaboration, professionalism, and effective communication in all interactions with internal staff, physicians, patients, caregivers and payers.
You are worth more than a paycheck. Our Benefits Raise the Bar: * 401(k) with an employer match up to 9% * Employee Stock Purchase Plan * Tuition Reimbursement * Paid Family Leave * Medical Plan Options, Dental & Vision * And much more!
Equal Opportunity Employer / EOE
Title: Care Navigator Registered Nurse
Location: Florida-Tallahassee-North Florida Shared Services
Requisition ID: 25086-11501