Based within the Central Health Navigation Center the LVN Navigator will support Central Health's Transitions of Care (TOC) programs by providing healthcare system navigation for patients discharging from the hospital, or
other acute care facilities ensuring the patient experiences a smooth care-setting transition. The LVN Navigator will also manage incoming referrals for post-acute care services, which may require referral transcription and navigation to the appropriate service line. The LVN Navigator will assist patients/members through inbound/outbound call support navigating them through the complex health care system.

This role is considered a hybrid role. The candidate must live in the Austin, Texas area. Individuals in this position may work both at an approved off-site location and onsite at a primary location or multiple locations based on business needs.

Essential Functions

• Assist hospital staff, community partners, and Central Health Transitions of Care teams navigate patients recently discharged from the hospital or other acute care facilities with securing appropriate medical care, Transition of Care (TOC) support, or other health care related assistance.
• Responsible for managing incoming referrals for transitions of care from community partners needing to access Post-Acute Care services, such as Transitional Dialysis, Case Management, educational programs, etc.
• Supports discharge and transitions of care planning to the next level of care by facilitating home health referrals, DME needs, expedited MAP enrollment, and appointment scheduling to ensure patients transition to next level of care.
• Serves as a primary Central Health Navigation Center contact for external providers (hospital, specialty and ER) and for patients of Central Health upon discharge from hospital or ER.
• Provide telephonic coverage and support within the Central Health Navigation Center for inbound calls, email, HIPAA compliant hospital SMS platforms pertaining to post-acute care service line patients, which include Transitions of Care, Medical Respite, and Case Management.
• Support programmatic activities such as clinical review of incoming referrals for services such as specialty care, diagnostic services, and review of daily triage patient encounters.
• Provide medical telephonic coaching, information and educational materials and resources to patients as needed.
• Educate discharge planners, physicians, and other appropriate referral sources regarding Central Health programs and programmatic criteria requirements.
• Enhances the patient experience by practicing AIDET during each patient interaction.
• Interact respectfully and collaboratively with patients and their families, striving to develop favorable relationships with families.
• Ensure all tasks involving patient care, patient administrative processes and related duties comply with all regulatory and accreditation standards, departmental protocols, and the assigned worksites’ policies, procedures, and standing operating procedures.
• Adhere to State Board of Nursing and State Nurse Practice Act requirements and to other governing agency regulations.
• Attends staff meetings and education offerings both in person and via teleconference/online as required.
• Supports organizational initiatives to promote and maintain a strong positive workplace culture. Participates in continuous quality improvement projects in order to better serve the patient, family and healthcare system to improve the quality of service provided.
• Other duties as assigned.

Knowledge, Skills and Abilities

• High level of skill at building relationships and providing excellent customer and patient care.
• Ability to facilitate patient access across the healthcare continuum.
• High level of problem-solving skills to better serve patients and staff.
• Excellent verbal and written communication skills required.
• Ability to work collaboratively with both internal and external medical staff and external partners and organizations.
• Strong commitment to quality, efficiency, and effectiveness.

Required Education:

Graduation from an accredited school of Vocational School of Nursing

Required Experience:

2 years Experience working in a community-based organization, ambulatory clinic, home health, or hospital setting.

Required Licenses and Certifications:

Texas Licensed Vocational Nursing License

Basic Life Support (BLS) obtained through approved American Heart Association or Association of Red Cross.