Patient Care Navigator II

Heart & Vascular Ct-Cardiology
Full Time
Day Shift
8:00 - 5:00

Lexington Health is a comprehensive network of care that includes six community medical and urgent care centers, nearly 80 physician practices, more than 9,000 health care professionals and Lexington Medical Center, a 607-bed teaching hospital in West Columbia, South Carolina. It was selected by Modern Healthcare as one of the Best Places to Work in Healthcare and was first in the state to achieve Magnet with Distinction status for excellence in nursing care. Consistently ranked as best in the Columbia Metro area by U.S. News & World Report, Lexington Health delivers more than 4,000 babies each year, performs more than 34,000 surgeries annually and is the region's third largest employer.

Lexington Health also includes an accredited Cancer Center of Excellence, the state's first HeartCARE Center, the largest skilled nursing facility in the Carolinas, and an Alzheimer's care center. Its postgraduate medical education programs include family medicine and transitional year residencies, as well as an informatics fellowship.

Job Summary

Care Management is an advanced specialty collaborative practice that holds responsibility for providing ongoing care management services for high-risk, complicated patients. The Patient Care Navigator facilitates communication and coordination among all participants of the health care team and patient to ensure that the services provided promote quality, cost-effective outcomes. The Patient Care Navigator provides intensive care management in a process that includes assessment, planning, facilitation, implementation, coordination, monitoring and evaluation of the patient's needs.

Minimum Qualifications

Minimum Education: Associate's Degree or Higher in Nursing
Minimum Years of Experience: None.
Substitutable Education & Experience: None.
Required Certifications/Licensure: Current Registered Nurse;
Required to obtain ACM or CCM certification within 3 years from date of hire.
Required Training: Knowledge of guidelines and regulations relevant to care management and utilization management;
Ability to develop a thorough, comprehensive plan of care, to include options and goals, in collaboration with care team and patient;
Ability to act as an advocate for the patient to assure quality of care and attainment of appropriate goals;
Ability to access and interpret data, utilizing findings in determining plans of care.

Essential Functions

• Performs comprehensive assessment of patients either referred to the program or meeting criteria for triage for the program, to include but not limited to: assessment of patient's physical, functional, social and psychological status; assessment of cultural and linguistic needs; assessment of caregiver resources and available benefits.
• Develops and implements a patient-specific care plan which includes problems, interventions and goals. Communicates with patient's physicians, specialists, community agencies and vendors to ensure coordination of services. Works collaboratively with patient's physicians and members of the interdisciplinary team to assure communication and exchange of input related to patient's specific care needs. Utilizes clinical judgement, independent analysis, evidence-based clinical guidelines, patient preference, and input from interdisciplinary team in making decisions.
• Participates in Grand Rounds Case Conference with other Patient Care Coordinators to assure collaboration, communication and consistency in implementing the program. Fosters sharing of ideas and input. Appropriately identifies cases needing physician, manager, director or medical director review and routes accordingly.

Duties & Responsibilities

• Schedules follow up to assess progress toward goals and identify barriers to meeting goals. Celebrates successes with patient. Prepares and maintains appropriate documentation of patient care and progress within the care plan, following established protocol for documentation of all case interventions. Closes cases according to defined case closure procedure in a timely manner and in accordance with established guidelines.
• Acts as an advocate in the patient's best interest for necessary funding, treatment alternatives, timelines and coordination of care, with frequent evaluations of progress and goals. Continues to identify community and caregiver resources to ensure continuity of care during and after completion of the care management plan.
• Participates in the development of policies, procedures, desktop procedures, assessments and referral templates to facilitate the implementation of and compliance with new care management programs or requirements. Participate in development of processes for oversight and reporting in compliance with new care management programs and requirements.
• Performs all other duties as assigned.

We are committed to offering quality, cost-effective benefits choices for our employees and their families:

• Day ONE medical, dental and life insurance benefits
• Health care and dependent care flexible spending accounts (FSAs)
• Employees are eligible for enrollment into the 403(b) match plan day one. LHI matches dollar for dollar up to 6%.
• Employer paid life insurance - equal to 1x salary
• Employee may elect supplemental life insurance with low cost premiums up to 3x salary
• Adoption assistance
• LHI provides its full-time employees employer paid short-term disability and long-term disability coverage after 90 days of eligible employment
• Tuition reimbursement
• Student loan forgiveness

Equal Opportunity Employer
It is the policy of Lexington Health to provide equal opportunity of employment for all individuals, and to remain compliant with applicable state and federal laws and regulations. Lexington Health strives to provide a discrimination-free environment, and to recruit, select, on-board, and employ all employees without regard to race, color, religion, sex, age, disability, national origin, veteran status, or pregnancy, childbirth, or related medical conditions, including but not limited to, lactation. Lexington Health endeavors to upgrade and promote employees from within the hospital where possible and consistent with the employee's desires and abilities and the hospital's needs.