Advanced Registered Nurse

Clinical Nurse Navigator - Heart Failure

The Heart Failure Navigator is responsible for the care coordination and implementation of best practice elements across the health care continuum. Works in partnership with patients, care givers, physicians, physician practices, hospital personnel, and post-acute providers to collaborate, educate and implement strategies to improve the care of heart failure patients.

Implements best practice elements related to heart failure and chronic illness care across the health care continuum to ensure high quality coordinated care of patients.

Rounds on/reviews assigned patients regularly and evaluates patient progress with plan of care.

Communicates plan of care to patient and family and solicits concerns, questions, and issues for resolution.

Works as an interdisciplinary care team member to manage the care journey and anticipate care support and education needs of patients diagnosed with heart failure and other chronic illness.

Coordinates discharge medication process, pharmacy location, and insures patient has medications for discharge at applicable facilities.

Works with the hospital care transitions team to perform transition of care management to CHF patients after discharge from the hospital, successfully bridging the transition from hospital to outpatient care and preventing readmissions.

Remotely manages the care of heart failure patients, triages calls, and escalates high risk patients using remote assessment skills and nursing expertise with provider oversight.

Collaborates with Advanced Heart Failure cardiologists on patients with chronic heart failure and advanced heart failure, specifically partnering on early referrals for evaluation for advanced heart failure therapies (LVAD and transplant).

Exhibits an in-depth knowledge of disease processes, pharmacology, and current guidelines to develop comprehensive care support for patients and promote successful outcomes.

Exhibits strong communication skills using empathy and social intelligence to evaluate patient needs and promote patient engagement and self-care.

Provides community resource referral, patient education, and navigation at the entry point and across the continuum of care.

Actively participates in the process for operational improvement and quality improvement.

Initiates and maintains positive relationships with coworkers and physicians.

Education (BSN) Bachelor's Degree in Nursing (Required)

Work Experience 3+ years in clinical medicine. (Required) and Coronary Care and telemetry experience (Preferred)

Knowledge, Skills, & Abilities Thorough knowledge of nursing process and practice (Required proficiency) Outstanding written and verbal communication skills. (Required proficiency) Comprehensive understanding of local medical systems and resources (Required proficiency) Understands multiple computer systems including, but not limited to: UHCare EMR, Sorian Scheduling. (Required proficiency) Excellent time management skills and proactive approach to the needs of customers. (Licenses and Certifications Registered Nurse (RN), Ohio and/or Multi State Compact License (Required Upon Hire)

Travel Requirements 0%

Primary Location: United States-Ohio-Concord Work Locations: 7590 Auburn Rd Concord 44077 Job: Nurse Non-Direct Patient Care Organization: TriPoint_Medical_Center Schedule: Full-time Employee Status: Regular-ShiftDays Job Type: Standard Job Level: Professional

University Hospitals