Clinic RN Navigator - Heart &amp; Vascular Institute

apartment Arnot Health location_onElmira, NY, US

MAIN FUNCTION:

The Nurse Navigator is responsible for managing a patient's successful transition from hospital to home, throughout the clinic experience, and ongoing care providing disease management, care coordination and patient triage. The Nurse works collaboratively with interdisciplinary staff internal and external to the organization, participates in quality improvement and evaluation processes related to the management of the Transitional HeartCARE Clinic.

DUTIES AND RESPONSIBILITIES:

Identify and enroll appropriate patients into the Transitional HeartCare Clinic.

Perform ongoing patient assessments, triage, and monitoring of physical and cognitive needs while keeping providers informed of status changes.

Implement provider-directed care plans accurately and consistently.

Coordinate home‑based services such as home health, DME, and transportation based on patient needs and resources.

Serve as a resource on specialty medications, insurance coverage, and cost‑saving programs.

Act as the primary point of contact for Transitional HeartCare patients, including completing post‑discharge transitional phone calls.

Document patient information in the EMR, including vitals such as weights and blood pressures, and manage scheduling of follow‑ups and testing.

Communicate lab and test results to patients after provider review and maintain systems for tracking consults and reports.

Assist with diagnostic procedures such as EKGs, event monitors, and MCOT placements while adhering to infection control and safety standards.

Demonstrate patient-centered communication, maintain required certifications (e.g., CPR, Infection Control), and participate in mandatory educational programs.

EDUCATION:

Graduate of an approved registered nursing program with a current license as a registered nurse.

EXPERIENCE:

Minimum of 5 years working as a registered nurse.

Preferred:

Experience working in a Cardiology Clinic/Unit

PHYSICAL DEMANDS:

Routine office job.

Requires light, moderate, or considerable physical effort

Frequently lift 15 lbs, occasionally lift 25 lbs

EXPOSURE CATEGORY:

Category I. Tasks that involve exposure to blood, body fluids, or tissues.

** A.D.A. Essential Functions

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