Advanced Illness Nurse Navigator - Full Time 80Hrs/Pp - Bronson Battle Creek

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Location

BBC Bronson Battle Creek

Title

Advanced Illness Nurse Navigator - Full Time 80Hrs/Pp - Bronson Battle Creek

The Nurse Navigator will guide patients through the health care system, establishing contact with newly diagnosed (cardiovascular/stroke/ortho/oncology) patients within the care setting as early as possible in the episode. This position will work closely with primary care physicians, surgeons, specialists, ancillary services, and other health care facilities. He/she acts as a liaison between the patient and all of the services required within the system and in the community. The navigator offers patients and their families' psychosocial support, access to resources, and educates on disease specifics and treatment options. In addition, the position works with designated physicians and teams to develop and maintain clinical pathways and measure outcomes. The Nurse Navigator behaves in a professional manner, and consistently demonstrates and promotes the values of respect, honesty, care, and dignity for the patient and all members of the health care team. Within applicable service lines, this position coordinates care for patients in the Bundled Payment (BP) program. The Nurse Navigator will be responsible for ongoing evaluation, quality improvement and outcomes of the BP program patients within their service line scope. Employees providing direct patient care must demonstrate competencies specific to the population served.

Bachelor's degree in nursing and 5 years of professional nursing in specific service line or related area required. Master's degree preferred.

Licensed Registered Nurse in good standing with the State of Michigan; BLS certification required within 6 months of hire.

Must provide evidence of successful completion (or an approved audit) of a CPR training course within the past 2 years or successfully complete a CPR training course (or audit with approval) within 6 months of hire. 

Oncology Nursing Certification required within 3 years of hire (Cancer Care Center only)

BBC Cancer Center Only: Preferred Eligible Candidate:  BSN Required. Alternative Eligible Candidate: ASN with 7 years of experience in Oncology with agreement that BSN must be obtained within 3 years. 

Breast Nurse Navigator

The Breast Nurse Navigator will guide patients through the health care system, establishing contact with newly diagnosed Breast/Oncology patients and will work closely with Radiologists along with all other primary care physicians, surgeons specialists, ancillary services and other health care facilities. Within applicable service lines, this position coordinates care for patients according to the care plan program. The Breast Nurse Navigator is responsible for participation in the assessment, planning, implementation and evaluation of health services provided by Bronson.  Breast Nurse Navigator is an integral part of coordination and support for the patient as he/she moves through the continuum of care from the onset of diagnosis through treatment phases into Survivorship. 

Heart Failure Nurse Navigator

The HF NN serves as a clinical guide and advocate for patients admitted to BMH with Congestive Heart Failure. The role of the HF NN is to improve outcomes for patients with heart failure by providing education related to medication adherence, fluid management, and early signs of worsening symptoms. The NN will reinforce discharge instructions and support transition to home or post-acute settings. The HF NN will also coordinate any post discharge needs with outpatient heart failure programs, cardiology and primary care to prevent readmissions. Clinical expertise in heart failure and chronic disease management is required. This position will require weekend and holiday coverage on a rotating basis.

Advanced Illness Nurse Navigator

This role blends clinical expertise, care coordination, and compassionate communication to support patients with serious or life-limiting illnesses.

The Advanced Illness Nurse Navigator serves as a clinical guide and advocate for patients and families facing serious, chronic, or life-limiting illnesses at BMH. This role facilitates timely access to palliative and supportive care services, ensure alignment of care with patient goals and values, and supports high-quality coordinated care across settings. The Nurse Navigator collaborates with interdisciplinary teams to reduce symptom burden, prevent unnecessary hospitalizations, and improve quality of life.

This position will require weekend and holiday coverage on a rotating basis.

• Must possess excellent interpersonal, effective problem solving and prioritization skills, and the ability to process information in a confidential manner - Must be able to communicate clearly and effectively with patients, providers and other staff
• Has the ability to maintain patient confidentiality, work independently and think as well as function as an integral team member with other healthcare professionals
• Must also possess excellent computer skills and have ability to read, interpret, and analyze data from various computer systems and equipment - the operation of and full attention to a personal computer or CRT between 40 and 70 percent of the time.
• Must have excellent verbal, written and electronic communication skills
• Has the ability to maintain positive customer service
• Has the ability to establish effective working relations with patients, staff and physicians in a team environment
• Expresses thoughts clearly and concisely
• Listens attentively to understand information provided by others. Keeps necessary people informed and up to date
• Demonstrates effective presentation skills; projects credibility and poise - Leads patient education efforts such as classes and support groups - Attends staff, educational, and other meetings as required, presenting information/results as needed. 
• Can negotiate skillfully in tough situations with both internal and external groups - Can settle differences with minimum noise - Can win concessions without damaging relationships - Can be direct and forceful as well as diplomatic - Gains trust quickly of other parties to the negotiations
• Has a good sense of timing Work which produces high levels of mental/visual fatigue, e.g., interactive and repetitive or small detailed work requiring alertness and concentration for sustained periods of time
• Acts as a liaison between patients, physicians, ancillary and community services within the designated service line throughout the entire patient experience from diagnosis to post-discharge. May make post-discharge phone calls or home visits.
• Develops and maintains relationships with office staff, hospital department heads, participating medical professionals, and other relevant members of the health care team and works cooperatively as a member of the health care team and is responsible for ensuring smooth, efficient transition of care between services.
• Works collaboratively with the provider to: Evaluate and implement patient care plan for specified patients in collaboration with the care team.  Evaluate and implement patient care plan for specified patients in collaboration with the care team.  *Develop and provide patient and family with appropriate education tools.  *Reinforce teaching regarding patient plan of care.  *Ensures that the appropriate tests, diagnostics, and procedures are ordered for patients - Assist with implantation of dynamic patient-centered record - Ensure appropriate primary care and specialist follow up - Provide psychosocial support and access to resources for patient and family - Works with designated physicians and staff to develop and maintain clinical pathways.
• Assists in getting access to culturally appropriate, supportive care when and where possible.
• Maintains accurate, confidential records, documenting services provided and unmet needs. 
• Works with the healthcare team to achieve targeted cost per case goals for assigned patients. 
• Becomes familiar with various insurance and referral policies. 
• Maintains an awareness and working knowledge regarding the pace and process of (breast/cardiac/ortho/stroke/oncology) services towards the enhancement of services offered.  Participates and/or leads in the re-design of processes and other growth strategies related to operational and financial goals.  Establishes challenging goals that focus on quality, cost, growth and brand identity while maintaining the need and awareness of capacity and other limiting factors to appropriately address these opportunities. 
• Achieves scorecard action plans within parameters established - Keeps administrator and respective Medical Staff Leadership, staff and coordinators informed of progress, issues, etc. that impact the achievement of goals established.  *
• Proactively develops the Nurse Navigator role with the goals of improving the experience for referred patients and the referring physicians.   
• Involves regularly lifting of bulky or moderately heavy weights (i.e., up to 50 pounds), and occasionally assisting with heavier tasks or expending the equivalent effort in pushing, pulling, or otherwise handling material, equipment, and other objects. (up to 100 lbs)

In the office-based role- Leads and/or participates in the identification of high-risk patients prior to elective surgery and facilitates the optimization of their health status prior to their scheduled procedure including referrals for co-morbid conditions, weight management and/or smoking cessation. 

In the hospital-based role- Participates in multidisciplinary rounds and/or conferences and acts as a resource for clinicians and case managers to assure that patient care plan is followed for the assigned programmatic clinics.  Involvement in Value Based Programs:  Engages all participating patients and families and makes them aware of plan of care for the episode, information resources, support programs and services.  *Acts as a representative of the program within the entire community, participating in public speaking and other related activities, especially within the organization.  *Maintains any required database for the patients and or program by inputting required patient data, as well as, tracking patient volumes, clinical outcomes and patient satisfaction.  *Establishes action plans that support Bronson's key initiatives for the BP program. Travel is required for this position (as we serve Kalamazoo and Calhoun County with Nurse Navigator services)

ESSENTIAL DUTIES & RESPONSIBILITIES (Breast) Nurse Navigator

Keeps in contact with patients as they are receiving their care.  Rounds daily on all assigned patients.

Participates in multidisciplinary rounds and/or conferences.

Engages all Medicare bundled payment patients and families and makes them aware of plan of care for the episode, information resources, support programs and services.

Acts as a representative of the BP program within the entire community, participating in public speaking and other related activities, especially within the organization.

Proactively develops the Nurse Navigator role with the goals of improving the experience for referred patients and the referring physicians.

Ensures that the appropriate tests, diagnostics, and procedures are ordered for patients.

Assists with implantation of dynamic patient-centered record.

Becomes familiar with various insurance and referral policies.

Acts as a resource for clinicians and case managers to assure that patient care plan is followed for the assigned programmatic clinics.

Is cognizant of the rising cost of healthcare and how that impact consumers (patients).

Develops and ensures developed budgets effectively utilize resources (both human and financial).

Monitors budget adherence and identifies trends or issues that may jeopardize achievement of same.

Puts appropriate action plans in place to ensure achievement of budget goals.

Shift

First Shift

Time Type

Full time

Scheduled Weekly Hours

40

Cost Center

2450 Case Management/Medical Social Work (BBC)

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