RN Nurse Navigator - Care Connect

Job Title

Company: Allegheny Health Network

Job Description

Preferred candidates will live within the Pittsburgh or Erie region. This job consists of working in a high-volume, fast-paced call center environment in which the nurse assists all callers—such as referring physicians, patients, caregivers, families, and the community—with coordination of patient services through clinical triage and scheduling. Facilitates patient flow, including coordination of appointments and assists the patient with accessing clinical and supportive care services within the Network. This job coordinates focused aspects of care in collaboration with the multidisciplinary team for adult/pediatric patients to ensure they receive quality and comprehensive services. Identifies caller needs and provides education, screening, support, referrals, coordination of care, and any other assistance identified as necessary.

Essential Responsibilities

• Serves as preliminary contact for AHN patients by greeting patients via telephone in a pleasant and professional manner, prioritizing patient inquiries, ensuring that accurate demographic and payor information is correctly reflected in the billing system, maintaining a positive customer service attitude when dealing with the public and AHN personnel, working effectively as a team member by offering support and/or ideas to enable the group to reach group goals. (25%)
• In a call center setting, provides professional nursing assessments, prioritizes treatments according to the urgency of need, and collaborates with other departments to appropriately coordinate patient services. (20%)
• Assists non-clinical staff with clinical issues and questions. (20%)
• Coordinates appointments including aspects of the multi-disciplinary team (physicians, consults, supportive care services, etc.). (10%)
• Works with AHN physician offices/facilities to identify at-risk patients and assists in facilitating appropriate screening processes. (10%)
• Works inbound or outbound call projects as assigned. (10%)
• Performs other duties as assigned or required. (5%)

Qualifications

Minimum:

• High School / GED
• 1 year of nursing in the specialty
• Act 34 Criminal Background Clearance Certificate
• Act 33 Child Abuse Clearance Certificate
• Act 73 FBI Fingerprinting Criminal Background Clearance Certificate
• Current State of PA RN licensure OR current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC).
• CPR certification

Preferred

• Bachelor's Degree in Nursing
• 1 year in an emergency room/ICU role
• 1 year with adult medicine/surgery
• 1 year in a call center or tele-health setting
• Certification in area of expertise
• Valid PA driver's license may be required
• Older Adults Protective Services Act (OAPSA) clearance may be required depending on location

Disclaimer

The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement

This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range

Minimum: $34.29

Maximum: $54.25 Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at View email address on click.appcast.io