Nurse Navigator
Core
Collaborates with patients and primary care providers to triage calls, assess needs, provide clinical dispositions, facilitate referrals, and coordinate care plans to ensure quality, efficient, and cost-effective healthcare services.
Role type
Nurse Navigator (Care Coordination & Utilization Management)
Builds
Individualized patient care plans, referral pathways, and coordinated service transitions
Domain
Healthcare / Managed Care / Utilization Management
Required skills
Registered Nursing licensure, Basic Life Support certification, patient triage, care coordination, risk stratification, clinical documentation, health education, utilization management, financial management, quality screening, data analysis, process improvement
Preferred skills
Bachelor of Science in Nursing (BSN), prior care coordination experience, 5+ years of nursing experience
Technologies
Established software, online resources, telehealth platforms
Responsibilities
Triage incoming patient calls and assess needs; Provide immediate care advice and preventative health education; Facilitate referrals and schedule clinic/telehealth appointments; Coordinate individualized plans of care with the healthcare team; Monitor clinical and financial indicators to drive continuous improvement; Identify gaps in care and implement evidence-based clinical interventions; Analyze utilization patterns and metrics to optimize quality and efficiency.
Seniority
Mid-level, hands-on IC