Job Description
DescriptionSummary:
The Registered Nurse Patient Navigator Lead is a Registered Nurse or licensed
Nurse Practitioner who provides health and wellness coaching, case management services, analysis and
expertise regarding CHRISTUS services. These services will be provided by monitoring cases and
claims, analyzing biometric and health risk assessment data, organizing disease management programs
and proactively interacting with members, physicians and other providers. Incumbent oversees
integrated data warehouse including program utilization, disease management programs and contracted
provider network support.
The CHRISTUS Children’s Hospital, established in 1959, was the first
children’s hospital in South-Central Texas. Located downtown, this 190-plus-bed hospital serves more
than 70,000 children annually from San Antonio, South Texas and around the world. The hospital (in
partnership with Baylor College of Medicine) is the only academic children’s hospital in San
Antonio. Our highly specialized services meet the unique medical needs of children, from Pediatric
and Neonatal Intensive Care to Children’s Emergency Services, the latest treatments for deformities
of the spine including titanium rib implants and halo traction, a Heart Center, a specialized asthma
program, a highly regarded Cancer and Blood Disorders Center, and growing maternal services to
include consultation, delivery, and maternal fetal medicine.
Responsibilities:
Oversee the
development, implementation and management of an integrated medical benefit program including case
management and health/disease management.Establish a system for coordinating the caseload patient's
care throughout the continuum of care.Use standard tools, databases and methodologies to support the
health benefit program and provide leadership in managing cases, events and diseases that are
determined to be targeted priorities by Senior Management of contracted employers.Interact with
providers and plan members in case management medical activities to provide the most efficient and
effective service.Identify targeted chronic diseases/high risk individuals (with vendor support) and
develop programs to reduce the financial and health risks, using internal hospital programs/services
whenever possible.Monitor and evaluate the effects of case management on the patient
population.Create outcomes-management focus by interdisciplinary analysis of specific clinical,
financial and satisfaction elements for the patient population.Assist in the analysis of
demographics, utilization and reimbursement.Prepare cost analysis and other reports to determine the
reasonableness of claim/cost data and utilization rates.Make recommendations based on data analysis
for benefit structure, pharmacy formulary, deductibles, co-pays, out of pocket, etc. to contracted
employer groups.Maintain consistent attendance, punctuality and personal appearance in accordance
with CHRISTUS attendance and dress code policies.Uphold organizational values by treating others
with respect, keeping commitments and working ethically and with integrity.Attend meetings as
required and participate in team activities. Exhibit confidence, motivate and inspire
others.Establish and maintain effective working relationships with team members, patients and the
public by demonstrating the ability to communicate verbally and in writing while responding clearly
and effectively.Demonstrate the ability to read and respond to e-mail and appointment requests in a
timely manner and on a regular basis.Use time efficiently, plan for additional resources, set goals
and objectives and work in an organized manner.Demonstrate safety practices and maintain a safe
environment for patients, visitors and fellow team members by following established safety and
infection control standards. Job Requirements:
Education/Skills
Associate's Degree
in Nursing
Experience
5 to 7 years of experience
Licenses, Registrations, or Certifications
RN
License in state of employment or compactBLS
Work Schedule:
Varies
Work Type:
Full Time
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Additional Information:
- Specialty: RN
- Location: 333 North Santa Rosa StreetSan Antonio, Texas 78207
- Contact:
About the Company:
CHRISTUS Health is an international Catholic, faith-based, not-for-profit health system comprised of
more than 600 services and facilities, including more than 60 hospitals and long-term care
facilities, 350 clinics and outpatient centers, and dozens of other health ministries and
ventures.
Sponsored by the Sisters of Charity of the Incarnate Word in Houston and San Antonio and
the Sisters of the Holy Family of Nazareth, the mission of CHRISTUS Health is to extend the healing
ministry of Jesus Christ.
To support our healthcare ministry, CHRISTUS Health employs approximately
45,000 Associates and has more than 15,000 physicians on staff who provide care and support for
patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United
States.
EXTENDING THE HEALING MINISTRY OF JESUS CHRIST
We are inspired by our mission, vision and
core values to deliver compassionate, high quality health care, improving the health of the
communities we serve. Above all, we are committed to providing our customers and their family
members with a truly unique healing experience, one that embodies our values and respects the
dignity and worth of each person. Creating a health care system that is truly excellent in all areas
is an ongoing effort.