Memory Care and Neuroscience Nurse Navigator

Overview

Works collaboratively to identify, design, and deploy best practices for GUIDE and other neuroscience programs.

Overview

Works collaboratively to identify, design, and deploy best practices for GUIDE and other neuroscience programs.

Responsibilities

• Promote the mission, vision and value of ARH and the neuroscience service line
• Maintains quality oversight of program and patient care delivery
• Interprets business data to contribute to decision making
• Works collaboratively to identify, design, and deploy best practices for GUIDE and other neuroscience programs
• Engages with facility and clinic leadership
• Excellent verbal and written communication and interpersonal skills
• The ability to problem solve and build teams
• Ability to use intermediate features of Microsoft Office products including Outlook, TEAMS, Word, Excel, PowerPoint
• Excellent organizational skills
• Administrative and managerial skills including project management
• Ability to function independently with simultaneous projects and priorities
• Innovative approach to problem solving
• Oversee daily operations of CMS GUIDE model initiatives and patient care navigation
• Collaborate with ARH providers and community resources to enroll patients in GUIDE model services
• Ensure required documentation present for patients including comprehensive assessment, home visit, caregiver assessment.
• Development of comprehensive care plan in conjunction with interdisciplinary care team.
• Work with ARH internal partners including IT governance/Meditech, ambulatory leadership, revenue cycle, community development
• Provide patient and caregiver with informational tools and resources
• Serve as primary point of contact for patient and maintain contact frequency per guidelines
• Coordinate care with primary care provider and other specialists caring for the patient
• Maintain inventory of community resources available for patient and caregiver needs
• Referral of patients to community-based services
• Provide patient and caregiver support to maintain medication as scheduled
• Administration of caregiver support program including the following: skills training, diagnosis information, support groups services and support calls.
• Arrangement of respite services as indicated for patient and caregiver
• Complete required training as outlined by regulatory/CMS standards
• Education of internal and external partners on available services
• Attendance at meetings, workshops or other required trainings
• Remain informed about current Alzheimer’s/dementia care and treatments
• Help develop and maintain high quality documentation (including EMR) related to the program including quality reporting, health related social needs
• Promotion of the program through multiple sources including networking, community outreach, social media and other forms of communication
• Facilitate ongoing community engagement programs and work with external agencies, including Alzheimer’s Association and Department of Public Health
• Facilitation of support groups
• Develop and update materials and resources for patient and caregivers
• Conduct training and information presentations related to the GUIDE and other neuroscience programs

Education

• Bachelor’s Degree in Nursing preferred with current licensure in KY/WV or compact state

Minimum Work Experience

• Prior 2-3 years of experience in aging, Alzheimer’s/dementia, patient care navigation or other related field
• Leadership and/or program management experience preferred

Required Skills, Knowledge, And Abilities

• Excellent written and verbal communication skills
• Administrative or managerial experience with ability to oversee projects and multiple priorities
• Ability to build collaborative relationships with internal and external customers