What are the responsibilities and job description for the Palliative Care Nurse Navigator, Full-time position at Transitions LifeCare?
Job Details
Description
Position Summary:
This is a full-time professional position responsible for coordinating care for patients enrolled in Community-Based Palliative Care and other assigned Palliative Care programs. The Nurse Navigator will triage incoming patient calls, conduct patient visits via telehealth and in-home care, and provide education to patients and families. This position will also collaborate closely with interdisciplinary teams across the agency, ensuring timely communication with referral sources and seamless transitions in care. The schedule for this position is Monday-Friday 8:30am-5:00pm.
Key Responsibilities
Description
Position Summary:
This is a full-time professional position responsible for coordinating care for patients enrolled in Community-Based Palliative Care and other assigned Palliative Care programs. The Nurse Navigator will triage incoming patient calls, conduct patient visits via telehealth and in-home care, and provide education to patients and families. This position will also collaborate closely with interdisciplinary teams across the agency, ensuring timely communication with referral sources and seamless transitions in care. The schedule for this position is Monday-Friday 8:30am-5:00pm.
Key Responsibilities
- Triage phone calls for palliative care patients.
- Follow up with clinicians regarding administrative needs, including obtaining and faxing physician orders, reviewing labs, and securing consents for patients in skilled nursing and assisted living facilities.
- Work with Medical Social Workers (MSWs) to facilitate patient visits as needed.
- Maintain scheduled phone contact with assigned patients.
- Conduct patient visits to provide education, obtain consent, and assess care needs.
- Facilitate discussions on end-of-life care and assist with transitions to hospice when appropriate.
- Assign acuity levels to new palliative care referrals.
- Participate in interdisciplinary team meetings.
- Coordinate communication between palliative care and hospice teams for assigned patients.
- Support providers and facility staff in identifying patients appropriate for palliative care, grief services, or hospice.
- Assist with the transition of patients between agency programs.
- Provide community resource information to patients and families.
- Document all communications and findings in the electronic medical record.
- Promote agency services to the provider community to increase referrals and patient engagement.
- Maintain palliative care database and participate in training and professional development.
- Current NC RN license (BSN preferred).
- Minimum of 3 years of recent clinical experience, with at least 2 years in home health or hospice (office nursing experience preferred).
- Strong verbal and written communication skills.
- Ability to manage multiple projects and priorities effectively.
- Knowledge of Medicare regulations, reimbursement sources, licensing laws, and accreditation standards.
- Proficiency with electronic medical records and general computer skills.
- Current CPR certification.
- Reliable transportation and ability to travel within the service area.
- Valid NC driver’s license with auto insurance.
- Ability to lift up to 35 lbs and perform physical assessments.
