Licensed Vocational Nurse (LVN) FT - Days - Nurse Navigator - Transitional Care Management (Carelink)
Responsible for follow up communication and coordination for continuum of care. Responsible for addressing any barriers and will communicate with department directors and physicians as required.
- License Vocational Nurse (L.V.N.)
- Current Texas licensure
- Minimum of two year of clinical or related hospital experience
- Ability to communicate clearly and concisely with all levels of nursing, administration, and physicians
- Demonstrated leadership experience
- Ability to read, write and speak English required
- Ability to speak Spanish preferred
Representative challenges of this position include having a high degree of competency/experience in general. Requires good communication and organizational skills. Must Requires reasoning ability and good independent judgment. Must project a professional image. Working knowledge of personal computer and software applications used in job.
- Responsible for phone-based interaction with patients after discharge
- Inform patients of abnormal laboratory results
- Educate patient and/or caregiver on disease specific education
- Coordinate follow up care with Primary Care Physician or Specialist as necessary
- Identify barriers to compliance with plan of care
- Refer to Care Link Clinic when needed
- Coordinate access to clinical and community based resources as appropriate
- Respond to triggers that may indicate intervention is required
- Assists with monitoring and continually assess the success of problem resolution activities.
- Completes and maintains records for problem status for follow-up.
- Maintains and distributes corrective action reminder report to responsible persons.
- Assist with meetings and disseminates information to appropriate areas, as directed.
- Able to travel and make home visits as needed.
- All other duties as assigned.