RN, Registered Nurse Patient Navigator Senior - Tyler Primary Family MED Job at CHRISTUS Health, Tyler, TX

TVFkMkNIaVhxZFpQTTRudnlDalllYk8rV2c9PQ==
  • CHRISTUS Health
  • Tyler, TX

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 Type:

Full Time

Job Tags

Full time,

Similar Jobs

FORTRANS INC

Class A OTR Driver - Home WEEKLY! Job at FORTRANS INC

 ...safely and efficiently across various routes. This role requires a strong commitment to safety, adherence to regulations, and excellent driving skills. Drivers start at $.60cpm, plus an additional $.04cpm on all miles going to/coming from east of I81 and north of I66. No... 

UPS

UPS - Warehouse Worker/Package Handler $16-$35/hr Job at UPS

No experience requited, hiring immediately, appy now.Find out what youll become as a Package Handler at UPS. In this fast-paced warehouse job, youll lift, lower and slide packages up to 70 lbs. Youll typically work 3 - 4 hour shifts, approximately 17 - 20 hours ...

Capital One

Principal Associate, Workplace Security Job at Capital One

 ...Overview WeWork Reforma Latino (97001), Mexico, Ciudad de Mexico, Ciudad de Mexico Principal Associate, Workplace Security At Capital One, we dare to dream, disrupt and deliver a better way. Our goal is simplebring ingenuity, simplicity and humanity to an industry... 

Peraton

Graphic Designer Job at Peraton

 ...Program Overview Enterprise-level services curated to meet current and future evolving needs, including roles in areas like graphic design, content management, multimedia, data visualization, public affairs, training, records management, and policy strategy. About... 

AMN Healthcare

Pediatric Urology Faculty Job at AMN Healthcare

 ...Information - Why Ann Arbor? Ann Arbor is consistently ranked as one of the best places to live in the United States. The community offers: Exceptional public and private schools A vibrant, diverse cultural scene with world-class arts, dining, and entertainment...