Under general administrative direction for Bariatric Program, coordinates referrals from health care facilities and individual providers; provides a significant level of patient education related to illness and planned management and treatment. They will triage indicating needs taking primary responsibility for logistical concerns. The Nurse Navigator will act as the community liaison for support programming to ensure that the patients are aware of different services offered.
Essential Duties and Responsibilities include the following. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.
Liaison for Surgery/Bariatric patients in need of multiple service and support.
Provides navigation services by facilitating resources and processing applications for various patient assistance programs, including but not limited to financial, Medicaid enrollment, free or reduced cost medication, social security benefits, disability benefits, copayment assistance and insurance coverage.
Contact patient within two days of inpatient discharge for care coordination such as obtaining required specialty and PCP appointments w/in required timeline, social worker, home care set-up, medication reconciliation and ensures all summary of care documentation is available in the chart at pending visits.
Contact patient within set time frame for follow up after ED discharge for clinically appropriate appointment.
Provide appropriate clinical support, counseling, and education. Alerts provider to urgent situations that cannot wait until scheduled follow up.
Work with multi-disciplinary team to develop a plan of care focusing on reducing readmissions and addresses chronic disease conditions and social/environmental concerns that may lead to repeat hospital stays/visits.
Work with all members of the surgical and oncological team to seamlessly coordinate the care delivered and necessary support for patient and their family.
Clinic prep notes for new patient and returning patient which includes scanning notes/imaging, contacting referring physicians or imaging group, and contacting patients on any issues on items needed for visit.
In collaboration with patient's care team, provides long-term education and references to resources, psychosocial support, and advocacy after surgery resulting in optimal patient outcomes
Pull records needed for patient from Cerner and EPIC and scan in Allscripts.
Handout and review OR prep packet with patient.
Order lab work, schedule testing and biopsy that are ordered.
Assist providers in addressing insufficiencies in care provision by coordinating follow up, orders, and referrals.
The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Bachelor in Nursing. Current D.C. Licensure as a registered nurse or evidence of application for licensure in D.C.
Two years of experience as a registered nurse is required. Experience in public health or health/patient education preferred.
Ability to input data into the computer, and analyze data as requested. Must be able to communicate providing verbal feedback in a professional manner. Must be able to follow and understand instructions, and react favorably in all work situations. Must be mentally adaptable and flexible in dealing with a variety of people.
General supervision is received on a daily basis from an Administrator or Physician.
GW Medical Faculty Associates