Jack Byrne Center Nurse Navigator – Palliative Care

Jack Byrne Center Nurse Navigator
– Palliative Care**Lebanon, NH, USA**NursingPost Date Jul 13, 2021Requisition # 210002HS**Purpose:**The Palliative Care
– Jack Byrne Center Nurse Navigator serves as the patients personal GPS functioning as a member of the multidisciplinary team and serves as an advocate for patients with serious illness.The Palliative Care
– Jack Byrne Center Nurse Navigator’s primary function is to follow patients through care episodes and identify transition needs.

Navigators achieve this goal by building relationships with patients and physicians, coordinating the plan of care, assisting with appointments, transportation needs, education, resource provision and/or representation within the interdisciplinary care environment.

The Navigator also assumes responsibility and accountability for the management of resources to achieve efficient, high-quality outcomes for patients, including support with interdisciplinary and cross-facility coverage and collaboration.The Navigator will serve as a liaison between the patient and family, all physicians involved in that patient’s care, internal and external healthcare providers, support network members, and the wider healthcare community.

This role will require collaboration with internal and external care providers and facilities to coordinate care for patients.**Key Responsibilities:**1.

Serves as patient advocate for patients with serious illness.2.

After notification via a member of the care team and/or eD-H software, initiates contact with patient at time of first contact to introduce navigation program and Navigator role.3.

Is accessible to patients and family members throughout the care continuum, and be responsive, knowledgeable, and empathetic regarding all care needs.4.

Responds to patient challenges/barriers to care until resolution is achieved.5.

Assesses patients’ medical, social, psychosocial, and other care needs.6.

Uses appropriate tools to identify patient needs and barriers to care and provide access to potential resolutions.7.

Identifies health disparities and assists in removal of these disparities.8.

Provides appropriate teaching, outreach, and support to patients and families.

Ensures the patient or health care proxy is empowered to manage healthcare needs.9.

Provides navigation through the healthcare system throughout the course of serious illness care.10.

Collaborates with the care team to assist patients in understanding their diagnosis, treatment options, and the resources available, including education, clinical research studies, and technologic advances.11.

Provides education/connection to resources i.e.

access to supportive care, financial support, return to work.12.

Streamlines processes for patients by assisting with appointment scheduling and paperwork preparation.13.

Ensures the organization of appointments.14.

Ensures smooth transitions between care modalities, facilities, and providers.15.

Introduces patients to appropriate caregivers, as needed.16.

Facilitates patient movement through the appropriate clinical pathway and collaborates with physicians to ensure patient compliance.17.

Coaches and assists patients to remove barriers related to insurance coverage, transportation, childcare, finances, language, etc.

so they can focus on their care, not barriers to care.18.

Connects patients to hospital and community resources.19.

Conducts follow-up conversations with patients and communicates any concerns, changes, or social needs to the appropriate physician or other care provider.20.

Attends Interdisciplinary Team meetings and/or other meetings, as necessary.Serves as a patient advocate and interdisciplinary team member at these meetings21.

Ensures that appropriate patient data is available and patient information is complete and accurate.22.

Documents throughout patient care continuum in eD-H database.23.

Collaborates with, physicians, and other team members to ensure data collection is timely and accurate.24.

Drive process improvement by collaborating with Nurse Manager, Palliative Care Section Chief and Jack Byrne Center Medical Director to determine programmatic and operational opportunities for improvement.25.

Makes appropriate recommendations for changes to the current program, both locally and at a corporate level, and assist in delivering program improvement.26.

Conducts outreach to referrers, providers and other medical professionals.27.

Establishes and maintains positive working relationships with key internal and external customers.28.

Educates each constituent on the role and benefits of the navigation program and high-quality Palliative & Hospice care.29.

Recognizes scope and limitations of role and regularly collaborates with the Nurse Manager as a support to the navigator role.30.

Provides referral sources with timely feedback on patient progress.31.

Stays current on the latest Palliative & Hospice care developments and participates in professional conferences.32.

Ensures service continuity and establishs appropriate mechanisms to ensure service continuity during both planned and unplanned absences and undertake succession planning.33.

Performs other duties as required or assigned.**Minimum Qualifications:**+ Graduate from an accredited Nursing Program required.+ Bachelor of Science Degree in Nursing (BSN) required; Masters preferred.+ Strong organizational skills and the ability to prioritize and reprioritize+ Ability to develop collaborative relationships internally and externally+ Strong oncology knowledge+ Basic computer skills+ Ability to work autonomously**Required Licensure/Certification Skills:**+ Licensed Registered Nurse in New Hampshire required.+ Nurse Navigation Certification required within two years of hire