Community Based Nurse Navigators – RNs

The Community Based Nurse Navigator (CBNN) is accountable for the high-risk patient population of Tandigm PCPs. As such, s/he takes responsibility for ensuring the continuity and coordination of patient care delivery by assessing patient needs; developing (in collaboration with the patient, patient family, and PCP) a Plan of Care (POC) that addresses those needs; identifying and leveraging appropriate resources (within the parameters of established networks, programs, and policies) to implement the POC; and regularly evaluating patient progress against the POC. The CBNN performs clinical assessments and provides nursing care within the scope of practice and licensure. The CBNN works with primary care physicians, nurse practitioners, and specialists to facilitate immediate treatment and coordinate care to ensure quality patient care. Finally, the CBNN communicates patient care updates and other relevant information to all stakeholders (Care Team Manager, PCP and office staff, Medical Director, ancillary providers) in a timely and reliable manner.

The CBNN uses advanced nursing knowledge, evidence-based best practice, critical thinking skills, and excellent oral and written communication skills to ensure appropriate utilization of resources and patient quality outcomes.  To all of this, the CBNN candidate brings a passion for the work, a belief in the role, and a commitment to the patients and physicians served.

The CBNN carries out the majority of these responsibilities in the field, meeting patients and providers in PCP offices and other community based settings, augmenting patient encounters telephonically as needed and appropriate. The schedule for this full-time exempt position is Monday through Friday, generally 8 AM-4:30 PM, though some evening and/or Saturday hours may be required to accommodate patient and/or PCP schedules. In-person attendance at corporate headquarters for regularly scheduled clinical rounds, department staff meetings, and company-wide meetings is required.

Education

  • Bachelor’s degree from a four-year college and/or a professional certification requiring formal education beyond a two-year college; graduate of an accredited school of nursing (preferred).

Licenses/Certifications

  • Pennsylvania RN license in good standing
  • Valid U.S. State Driver’s License as well as proof of (Auto) liability and (Auto) property damage insurance on any vehicle used for business purposes.

Experience

  • Must have a minimum of five years of nursing experience in an acute care setting preferred, plus an additional 2 years of nursing experience in an ambulatory care setting; and case management, utilization review, discharge planning, and/or nurse navigation experience.experience working/interfacing in a primary care physician office.

Requirements

  • Share our passion and our mission for making healthcare better !  We are looking for a nurse (with passion for community-based, team-oriented population health that is PCP-led, patient-centered, and focused on clinical and quality outcomes!
  • Reliable personal transportation for traveling within the five county Philadelphia region, as required
  • Excellent interpersonal communication skills and the ability to represent Tandigm Care Delivery Support in a community setting
  • Proficiency in computer skills, including Microsoft Office, EMRs, and other clinical databases
  • Accuracy and attention to detail
  • Ability to multi-task, i.e., chart clinical data during patient encounters
  • Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross)
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