Nurse Care Navigator

PRINCIPAL DUTIES & RESPONSIBILITIES 

Clinical Review & Referral Management 

• Review incoming referrals to ensure they meet Transplant Center Evaluation Guidelines 

• Request and place orders for referral testing per protocol for acceptable candidates 

• Consent patients and secure consent for transplant evaluation per Transplant Center Protocol 

• Provide CMS transplant education per Transplant Center Policy 

Health Maintenance Screening 

• Assist patients in completing health maintenance screening tests not on the standard UNOS-required list 

• Schedule health screening tests with hospital services and external partners 

• Identify local partners (e.g., radiology centers, cardiology clinics) to perform necessary testing 

• Assist patients in obtaining dental care as needed per Transplant Center policy 

• Develop clear algorithms for special-case scenarios (e.g., commercially insured patients requiring testing at the parent hospital) 

Results Review & Anomaly Management 

• Review results and discuss abnormal findings with the designated Transplant Center physician or designee 

• Maintain a real-time tracking system for test completion, results collection, and anomaly review 

• Maintain a clear communication pathway with the Transplant Center MD for escalating abnormal results 

• Coordinate communication of abnormal results to patients per pre-agreed procedures 

• Track and follow up on missing or incomplete tests 

• Guide management of patients who repeatedly miss scheduled appointments 

Scheduling & Patient Coordination 

• Confirm patient intent and attendance with the dialysis clinic social worker (MSW) 

• Communicate with the FKC MSW regarding patients who are difficult or impossible to schedule 

• Escalate scheduling barriers to the attending nephrologist to assess candidacy or psychosocial obstacles 

Billing & Reimbursement 

• Coordinate billing and reimbursement for testing with the Transplant Center Financial Coordinator 

• Ensure testing is billed through the Transplant Center and not directly to the patient 

• Distinguish initial screening testing (billable to transplant center) from follow-up testing (billable to patient insurance) 

• Participate in periodic audit trails of billing documentation 

Stakeholder Relations & Reporting 

• Arrange lobby/practice days with Transplant Center personnel as appropriate 

• Coordinate joint population-level reviews between practices, clinics, and transplant centers 

• Solicit feedback from patients, referring physicians, and transplant center staff on TCN operations 

• Provide continuous updates to Operations Management regarding the clinical posture of assigned centers 

• Perform other related duties as assigned 

PHYSICAL DEMANDS & WORKING CONDITIONS 

The physical demands and work environment described here are representative of those encountered while performing the essential functions of this role. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. 

• Remote/work-from-home position 

• Day-to-day work involves desk and computer work, with interaction with patients, facility staff, and physicians 

• Travel between assigned centers required; travel to organizational meetings may be required 

SUPERVISION 

This position has no direct supervisory responsibilities. 

EDUCATION & CREDENTIALS 

• Graduate of an accredited School of Nursing; RN BSN required — advanced degree preferred 

• Current appropriate state licensure 

• One multistate license with the ability to practice in all compact states 

EXPERIENCE & SKILLS 

• Minimum 5 years of experience in pre-transplant intake, patient education, ICU, or similar clinical setting 

• Solid understanding of the relationship between healthcare providers and regulatory agencies 

• Ability to analyze complex issues and propose alternative solutions 

• Experience in quality management, risk management, case management, and infection control 

• Excellent verbal and written communication and interpersonal skills 

• Exemplary customer service orientation 

• Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint); medical database software required 

• Proficiency with EPIC preferred