Nurse Navigator, DSNP

Must have five (5) years experience as an nurse, three (3) of those years may be work experience as a nurses aide, LPN or other appropriate position in a clinical setting. Must have an a ctive Ohio or WV licensure upon hire. Ohio or West Virginia multistate licensure must be obtained within the 90-day probationary period and maintained throughout employment. The D-SNP (Dual-Eligible Special Needs Plan) Nurse Navigator is responsible for the navigation and advocacy of members who are dually eligible for both Medicare and Medicaid. These members often have multiple or complex medical and/or behavioral health, socioeconomic, and functional needs that require comprehensive care coordination services. These services may include navigation beyond the specific case or situation, providing the member with a wide spectrum of services directed at not only medical or behavioral changes but healthy lifestyles and optimal outcomes assuring quality and continuity of care within the managed care system. Care coordination directs intervention by offering education and support, liaising with providers of medical/behavioral services and equipment to facilitate effective communication, streamline referrals, assist in developing and implementing comprehensive individualized care plans, and supporting smooth discharge planning. This is achieved through the establishment of routine follow up to monitor, evaluate, revise or close care plan interventions and goals which support ongoing communication and interaction among the interdisciplinary care team and provides opportunities to appraise cases for quality of care. Complete job description available on company website.