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Steward Health Care System Patient Navigator in Fall River, Massachusetts

POSITION SUMMARY: The Nurse Navigator coordinates resources into a seamless model of access, care and support that benefits patient, family members and participating physicians. The Nurse Navigator addresses patient needs throughout the care continuum to reduce gaps in the care process and provide education (Diagnostic Phase); improve timeliness of care and coordinate complex care processes (Multidisciplinary Care); and develop plans for long term and survivorship care (Post Treatment Phase). The Nurse Navigator serves as a liaison between patient, PCP, surgeon, medical oncologist or medical specialist, and other providers and identifies personnel in departments involved with their care (i.e., physicians, nurses, radiology, social services, radiation oncology & hematology/oncology, etc.) and develop relationships with them. KEY RESPONSIBILITIES: • Provides support and guidance as patients navigate through complex health care issues and treatment. • Delivers direct and indirect patient care utilizing the nursing process through assessment, data collection, and prioritizing identified patient needs • Has a working knowledge of imaging procedures and is responsible for ensuring that patients and referring physicians promptly receive imaging procedures and is responsible for ensuring patients and referring physicians promptly receive imaging reports and the recommendations for follow-up to abnormal findings • Expedites access to care as patients and their families cope with a diagnosis and treatment • Serves as an educational resource and promote awareness for the facility and community on healthcare related topics. • Provide patient support in a one-on-one or group setting • Guides patients and families through the health care system from the time of diagnosis through their duration of care, by assisting them with access to needed services, developing relationships with various providers and tracking interventions and outcomes • Coordinates care to ensure safe, effective, efficient patient centered care that supports the whole person • Serves as a consistent care coordinator throughout the continuum of care assessing the healthcare barriers and the physical, psychological, and social needs of the patient • Collaboratively design a care plan with desired outcomes • Develop a care plan that addresses and removes healthcare barriers and meets the needs and expectations of both the patient and physicians • Enhance the patient's quality of life, sense of autonomy and self-determination for managing their own health • Promote an interactive relationship that keeps communications open among patient, family, nurse and physicians • Monitor for symptoms of exacerbation of disease or maladaptation to illness • Provide early intervention and appropriate access to healthcare services • Manage services throughout the continuum of care, decreasing fragmentation of care • Provide support to the patient and their family in understanding and coping with the strong emotions that accompany a diagnosis. Remains a constant caregiver and overseer of the patient's educational, emotional and social needs. • Provide educational resources for the patient and her family to answer their questions and address their fears during the experience. • Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment. 1. Commits to recognize and respect cultural diversity for all customers (internal and external). 2. Communicates effectively with internal and external customers with respect of differences in cultures, values, beliefs and ages, utilizing interpreters when needed. • Performs other duties as assigned REQUIRED KNOWLEDGE & SKILLS: Decision Making: Ability to make decisions that are guided by precedents, policies and objectives. Regularly makes decisions and recommendations on issues affecting a department or functional area. Problem Solving: Ability to address problems that are highly varied, complex and often non-recurring, requiring staff input, innovative, creative, and Lean diagnostic techniques to resolve issues. Independence of Action: Ability to set goals and determines how to accomplish defined results with some guidelines. Manager/Director provides broad guidance and overall direction. Written Communications: Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers. Oral Communications: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers. Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations. Strong analytic skills with quality and data analysis. Demonstrated use of clinical skills and expertise in the area of breast disease, breast cancer treatments and psychosocial impact of disease on recovery Team Work: Ability to act as a team leader for small projects or work groups, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments. Customer Service: Ability to provide a high level of customer service and staff training to meet customer service standards and expectations for the assigned unit(s). Resolves service issues in the assigned unit(s) in a timely and respectful manner. Ability to work collaboratively with multidisciplinary care team to develop and implement care plan EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER: Education: Associate's degree required. BSN Preferred Experience: 3-5 years related work experience required in clinical medical-surgical. Experience with interdisciplinary health care approach Software/Hardware: Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint