Registered Nurse | Care Continuum Navigator | Part Time
On-siteHagerstown, Maryland, United States
Job Summary
Coordinate seamless transitions of care by collaborating with Emergency Department, Inpatient Care Management, physicians, and community agencies to address high-risk, rising risk, and Multi-Visit Patients. Conduct comprehensive assessments to identify clinical, behavioral, and social factors driving healthcare utilization, then develop individualized care plans in partnership with patients and interdisciplinary teams. Facilitate discharge planning from the Emergency Department by connecting patients with appropriate follow-up care and community resources to reduce unnecessary hospital admissions. Monitor patient progress and evaluate the effectiveness of interventions using established quality metrics. Maintain accurate documentation and ensure compliance with organizational policies. Requires current Maryland RN license, care management certification, and 3+ years acute care experience. Schedule includes 32 hours biweekly, 11am to 7:30pm, with weekend options available.
Required Qualifications
- Associates Degree in Nursing
- Current license to practice as Registered Nurse in the State of Maryland
- Registered Nurse License from a Compact or Multi-State Privilege state
- Care/case management certification
- Minimum 3 years acute care experience and/or combined relevant experience in acute care Utilization role, SNF, or community health setting (for ASN)
- At least 2 years of acute care experience and/or combined relevant experience in acute care, utilization role, SNF, or community health setting (for BSN)
- Knowledge of care management principles
- Knowledge of professional practice standards
- Knowledge of health and public policy
- Excellent clinical skills
- Excellent interpersonal skills
- Excellent communication skills
- Ability to work collaboratively with other healthcare professionals
- Ability to work independently
- Experience with coaching while working with the chronic, complex population
- Knowledge of evidenced based practices
- In depth knowledge of disease processes
- Knowledge of community resources
- Proactive mindset
- Assertive mindset
- Creative problem-solving skills
- Proficiency in computer skills
- Proficiency in internet use
- Proficiency in information technology
- Proficiency in electronic medical record use
Desired Qualifications
- Bachelor's of Science in Nursing
- Experience in managed care
- Experience in medical home
- Experience in integrated care management environment
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