Nurse Navigator, Part-time

This is a fully remote position, open to applicants in California, +1 more state.

📋 Description

• Take charge of clinical navigation for individual members.

• Establish and maintain ongoing relationships with members, comprehending their needs, directing them to appropriate care, and ensuring adherence to care plans and subsequent actions.

• Evaluate and respond to platform suggestions.

• Address incoming clinical inquiries and manage members’ care across various providers.

• Actively engage with members throughout the year.

• Triage incoming clinical inquiries, assess their urgency, provide guidance, and appropriately route members.

• Direct members to suitable specialists, imaging, or procedures based on quality and cost considerations.

• Schedule appointments and ensure follow-through until all requests are fulfilled.

• Review data-driven recommendations and create or update member care plans.

• Accurately document interactions within established clinical workflows and guidelines.

• Escalate unfamiliar, sensitive, or clinically complex cases as necessary.

• Identify gaps in workflows, member experiences, and product offerings, and collaborate with the wider team on enhancements.

⛳️ Requirements

• Over 3 years of experience with significant time spent in care coordination, case management, population health, or telehealth.

• Proficient in clinical documentation; capable of articulating a care gap to a member in straightforward language.

• Comfortable working in asynchronous message-based workflows.

• BSN preferred; ADN will be considered if accompanied by strong care coordination or case management experience.

• Current RN license required.

• NLC compact licensure is necessary; NY and CA licensure required or a willingness to obtain them.

• CCM or ACM certification is beneficial but not mandatory.

• Spanish fluency is advantageous but not essential.

🏝️ Benefits

• Completely remote; option to work in-person at the NY office.

• Wellness stipend.