Nurse Navigator (RN), Navigation Center - Per-Diem/Evenings (Weekends)

Purpose Statement / Position Summary

To be the first reliable point of contact for Patients, Families and Providers. Providing the Simply Better MemorialCare Experience in every interaction with guests and colleagues.

Essential Functions and Responsibilities of the Job

1. Maintains working knowledge of the job functions of telephone advice nurse.
2. Assess and prioritize incoming calls.
3. Act as a resource to other departments.
4. Deliver the Simply Better MemorialCare Experience in every interaction with Patients, Families, Providers and Colleagues. 
5. Prioritize service and customer experience within each interaction.
6. Ensure unforgettable guest experiences through unmatched service.
7. Demonstrates strong guest-focused engagement over the phone, email, and chat.
8. Demonstrates effective communication, interpersonal, written and verbal skills.
9. Strong organizational skills.
10. Must be able to multi-task and maintain calm positive demeanor.
11. Must possess problem resolution and follow through skills.
12. Knowledge of managed care and the business segments.
13. Knowledge and ability to schedule reservations for patients/family.
14. Be at work and be on time.
15. Follow company policies, procedures and directives.
16. Interact in a positive and constructive manner.
17. Prioritize and multitask.

Essential Job Outcomes

1. Assess and prioritize incoming calls.  Assess symptoms over the phone.  Initiates first responders when the patient’s condition warrants.  Provide patient with advice, appropriate education and/or resources while adhering to authorized protocols.  Provide home care and teaching suggestions that adhere to physician guidelines.
2. Act as a resource to other departments (i.e. HBAT Nurses, Sutter Health nurses, Urgent Care staff, etc.)  Acts as a liaison between patient and physician/organization.  Communicates with all parties via EMR.  Hands off any incomplete or ongoing patient issue with next shift.  Reviews and acts upon critical labs as indicated.
3. Document clearly and concisely all incoming and outgoing calls per approved procedure in Patients Electronic Medical Record (EMR).
4. Make urgent/non-urgent appointments as indicated/approved per scheduling guidelines.  Follow up with patients recently discharged from the Emergency Room.  Review with patient all discharge instructions.
5. Notify Lead Nurse Navigator and Supervisor regarding vacation dates and absences. Assist in arranging coverage.
6. Maintains and demonstrates a complete understanding of the MemorialCare Refill Protocol.  Perform any additional/miscellaneous duties (not inclusive of job description) as requested by the management team within the scope of knowledge/ability.
7. Under minimal supervision and in a professional and friendly manner, performs all assigned job tasks to the highest level of accuracy and timeliness.
8. Must have a high level of computer knowledge and competency in multiple software system environments.
9. Must meet daily call standards, KPI’s (Key Performance Indicators), and document calls accurately.
10. Must be able to multi-task while speaking with the customer and perform research functions as well as maintain a professional demeanor and standard of excellence.
11. This position requires the documentation of each phone call before the call is completed and may require further follow up with continued documentation of each subsequent call for final resolution.
12. Ability to handle large volume of telephone work in call center environment. Potentially 50+ calls per day when call volume requires it.
13. Assists physicians, provider offices, health plans, and members with issue resolution, claims status calls, and referral management calls.
14. Assists in orienting and/or education of new members and acts as the first point of contact to new members.
15. Interfaces with health plans general policies and procedures as enumerated by their insurance policy.
16. Projects an image of professionalism in communication, appearance and conduct.
17. Participates in the continuous quality improvement process.
18. Maintains a working knowledge of department standard operating procedures, standard work, and leader standard work.
19. “Other duties as assigned.”