Summary

The Care Navigation Partner will deliver education, outreach, and in-person assistance to patients served. The care navigation partner will collaborate with stakeholders to triage and process telephone calls from patients, caregivers, and providers ranging from general information to more complex situations related to care management. Can conduct one-to-one extended patient meetings, perform follow-up with patients, family/caregivers, providers and community resources via e-mail, phone or other communications. Promotes timely access to appropriate care, works to reduce emergency room utilization and hospital readmissions. Creates and promotes adherence to care plan developed in coordination with the patient, primary care provider, and family/caregivers. The care navigation partner will also support practice quality work and gap closure efforts.

Job description

Summary

The Care Navigation Partner will deliver education, outreach, and in-person assistance to patients served. The care navigation partner will collaborate with stakeholders to triage and process telephone calls from patients, caregivers, and providers ranging from general information to more complex situations related to care management. Can conduct one-to-one extended patient meetings, perform follow-up with patients, family/caregivers, providers and community resources via e-mail, phone or other communications. Promotes timely access to appropriate care, works to reduce emergency room utilization and hospital readmissions. Creates and promotes adherence to care plan developed in coordination with the patient, primary care provider, and family/caregivers. The care navigation partner will also support practice quality work and gap closure efforts.

Job Duties

Focuses on chronic illness management as directed by care pathways and adjusts plan of care as necessary to reduce emergency room utilization and hospital readmissions accomplished by leveraging data analytics and population risk reports to prioritize and tactically respond.
Builds strong relationships to achieve patient goals and provide seamless care. In partnership with patient and care team develops and re-assesses patient goals.
Maintains contact with patient and relevant circle of support from initial connection as required/needed to promote best health outcomes.
Plans and facilitates patient education and ensures patients and family comprehension of care and interventions.
Supports practice quality efforts focusing on completion of health maintenance opportunities for managed population and assist practice with management of not met reports and portal outreach campaigns.
Completes pre-visit planning.
Assist patients with applying for community resources, including emergency financial assistance, housing assistance, access to foodbanks, and other community-based resources.

Minimum Qualifications

Bachelor’s Degree in nursing
3 years clinical experience in an inpatient or ambulatory setting
American Heart Association Basic Life Support - State of Pennsylvania
RN - Licensed Registered Nurse_PA - State of Pennsylvania Upon Hire

Preferred Qualifications

Master’s Degree in nursing

Requirements

Bachelor’s Degree in nursing
3 years clinical experience in an inpatient or ambulatory setting
American Heart Association Basic Life Support - State of Pennsylvania
RN - Licensed Registered Nurse_PA - State of Pennsylvania Upon Hire

Company overview

Lehigh Valley Health Network (LVHN) is a major healthcare provider and hospital network based in Allentown, Pennsylvania, serving the Lehigh Valley and Northeastern Pennsylvania regions. Founded in 1899, LVHN operates as a comprehensive healthcare system with 13 hospital campuses, 28 health centers, numerous primary and specialty care physician practices, and multiple urgent care locations. The network's flagship facility, Lehigh Valley Hospital-Cedar Crest, is Pennsylvania's third-largest hospital and features the state's first Level One Trauma Center. LVHN provides a wide range of medical services including specialized institutes for cancer care, heart and vascular treatment, surgical excellence, orthopedics, and neuroscience. The network operates the third-largest heart surgery program in Pennsylvania, performing over 1,200 open-heart procedures annually, and maintains one of the state's largest cancer centers treating over 2,400 new patients each year. In August 2024, LVHN completed a merger with Jefferson Health, becoming part of a larger healthcare system with 32 hospitals and over 700 locations across Pennsylvania. Prior to the merger, LVHN was the largest employer in the Lehigh Valley metropolitan region, with approximately 20,000 employees dedicated to providing comprehensive healthcare services to the community.