Nurse Navigator in Spartanburg, SC at Spartanburg Regional Healthcare System

Date Posted: 1/10/2020

Job Snapshot

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  • Job Type:
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    Not Specified
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Job Description

The Nurse Navigator participates in a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's health needs. On an aggregate level, the Nurse Navigator will track performance of the program in line with CMS, RHP and facility goals (growth, quality, practice guidelines, etc.) and identify opportunities to streamline care practice, for example through development of evidence-based guidelines. Must be flexible and adapt to changes in the work environment; manage competing demands; change the approach or method to best fit the situation; be able to cope with delay or unexpected events. Take responsibility; keep commitments; and complete tasks on time. Volunteer readily; take independent actions; ask for and offer help when needed.

Minimum Requirements


  • RN/BSN


  • Five years of experience in outpatient setting, population health, social services, home health, or other health care setting. Program management experience in a clinical setting.


  • Valid drivers license

Preferred Requirements

Preferred Education      

  • N/A

Preferred Experience   

  • Team Lead experience

Preferred License/Registration/Certifications  

  • N/A

Core Job Responsibilities

  • Actively manage high-risk members including members with complex medical and/or psychosocial problems through care coordination including closing care gaps, scheduling members for recommended follow-up, retrieving missing documentation, condition education, home/hospital visits and physician coordination.
  • Identify opportunities for intervention for each member.
  • Perform hospital and/or home visits for members within a designated time frame.
  • Coordinate with the team members on moderate/high risk members.
  • Develop a personalized care plan including self-management goals with each member, sharing each member’s self-management goals with the member’s care team including the member’s physician
  • Ensure the proper handling of patient records to ensure compliance with patient health information applicable to the preservation, accuracy, and completeness of communication and/or retention of patient information, meeting all HIPAA regulations and the HITECH Act provisions as required by law
  • Provide telephonic or face-to-face outreach to engage members to assess their readiness to change by using motivational interviewing techniques to help members identify and overcome barriers that often include behavioral risk factors, such as smoking, poor health literacy, sedentary lifestyle, elevated BMI, and poor disease management.
  • Proactively collaborate with providers, community resources, and other colleagues to help members achieve the best possible outcomes 
  • Must meet productivity standards set for by direct supervisor.
  • Serve as a back-up to other Nurses as needed
  • Provide clinical support, expertise and training, to Care Coordinators, Health Coaches, and other Nurses
  • Meet with the primary care providers and payers as needed to discuss quality, outcomes and clinical benchmarks for RHP contracts, documenting and reporting findings to management
  • Suggest and provide evidence-based medicine training for process and outcomes measures when provider outcomes fall below benchmarks
  • Participate in Care Coordination meetings and provide other CarePlus members with support
  • Contributes to team effort by accomplishing results as needed.
  • Achieves population health improvement goals.
  • Properly documents all communication in accordance with policies and procedures.
  • May perform other duties as assigned.