Registered Nurse (RN) - Nurse Navigator
PruittHealth
Gainesville, GA

Senior Nurse Navigator

JOB PURPOSE: Nurse Liaison will function as a facilitator to hospitals and community services in need of referring to our organization. Assists in the evaluation of patients to ensure that they are appropriate for admission to the home health or hospice agency. Provides clinical expertise to our home health and hospice agencies by evaluating their ability to meet the patient's clinical needs. In addition, this individual is a sales professional who focuses on the development of early and appropriate referrals by creating and sustaining business partnerships with facilities and hospitals. KEY RESPONSIBILITIES: 1. Fluent with all regulatory agencies, reimbursement systems and levels of care. 2. Must be knowledgeable of private insurance, Medicare and Medicaid coverage criteria, rules and regulations and reimbursement methodologies. 3. Taking responsibility for a regional territory of hospitals and community services in order to facilitate the placement of patients within the Pruitt Health continuum. 4. Duties include taking call for discharge planners in need of assistance, providing on site clinical assessments, completing necessary discharge paperwork, communicating referral needs within our continuum and facilitating admissions into the Pruitt Health network. 5. Must provide excellent customer service to all referral sources and network of providers. 6. Represents organization in various community efforts and education seminars 7. Develops business relationships by making effective sales contacts and presentations. 8. Builds relationships with the PruittHealth Home Health/Hospice staff teams to ensure the establishment of effective communication with referral sources and the staff teams. 9. Communicates well with patients/residents/clients and family members providing warm and friendly greeting and an approachable attitude to families, visitors, patients/residents/clients and responds to expressed concerns while displaying a helpful, caring demeanor. Answers questions when appropriate in a professional manner. 10. Reviews clinical, sales, and professional journals. 11. Reviews internal information, policies, publications, bulletins, etc. 12. Identifies territory assumptions which may influence the achievement of business goals. 13. Identifies key referring physicians. 14. Identifies key referring personnel in hospital, nursing homes, and other community facilities. 15. Communicates written plan to Vice President of Program Development and Community Relations Development Coordinator. Monitor, evaluate and adjust the plan as needed. 16. Completes call reports and documents daily activities 17. Develops plan for accounts management with input from staff teams. 18. Supports and participate in promotional activities. 19. Identifies existing relationships with competitive home health and hospice organizations, hospitals, nursing homes and physicians. 20. Develops, implements and evaluates quarterly and annual territory plans, strategies and actions to achieve negotiated goals. 21. Identifies case management, HMO, PPO, insurance companies and other payer referral sources. 22. Determines vulnerabilities of competitive relationships and set targets. 23. Joins and participates in appropriate organizations and associations. 24. Documents and reports complaints and service-related issues. KNOWLEDGE, SKILLS, ABILITIES: 1. Ability to develop clinical knowledge base to support sales activities. 2. Ability to effectively communicate both verbally and in writing with the different disciplines in the health care field. 3. Ability to identify and develop new referral sources. 4. Ability to manage a territory, to conduct sales calls and presentations, and to generate referrals by building long term business relationships. 5. Ability to prioritize, manage time, and maximize productivity. 6. Assesses training needs with Community Relations Development Coordinator and develop a written plan to enhance knowledge and skills. 7. Implements, modifies and evaluates the written plan for self-development. 8. Ability to implement strategies and actions which include effective sales calls, presentations, and use of collateral materials. 9. Participates in center/agency surveys (Licensure/JCAHO) and any subsequently required reports. 10. Attends and participates in continuing educational programs to keep abreast of changes in your field as well as to maintain current license/certification as required. 11. Attends and participates in mandatory in-services. 12. Honors patients/residents' rights to fair and equitable treatment, self-determination, individuality, privacy, property and civil rights, including the right to wage complaints. 13. Complies with corporate compliance program. 14. Reports job-related functions/tasks that involve occupational hazards including exposure to blood and body fluids and others as necessary. 15. Follows established safety regulations, to include fire protection and prevention, smoking regulations, infection control, etc. 16. Follows established safety procedures when performing tasks and/or working with equipment. MINIMUM EDUCATION REQUIRED: Two (2) years of college or business school and/or equivalent combination of experience and training. MINIMUM EXPERIENCE REQUIRED: Two (2) years' experience in home health and/or hospice. Healthcare sales/marketing, or any equivalent combination of experience and training which provides the required knowledge, skills, and abilities is preferred. MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW: Current RN license. RN or LPN graduates with current license. ADDTIONAL QUALIFICATIONS: (Preferred qualifications) Bachelor's Degree preferred Family Makes Us Stronger. Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference. We are eager to connect with you! Apply Now to get started at PruittHealth! As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.