RN, Registered Nurse Patient Navigator Senior - Specialty Cardiology - Full Time
Company: Christus Health
Location: Longview
Posted on: March 12, 2025
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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 for the health plan of employers contracting with
CHRISTUS for chronic disease and high risk case
management/population health management 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 plan members,
physicians and other providers. Incumbent oversees integrated data
warehouse for support of the health benefit program 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 for the health plan. --- 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:
Education/Skills
Keywords: Christus Health, Longview , RN, Registered Nurse Patient Navigator Senior - Specialty Cardiology - Full Time, Healthcare , Longview, Texas
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