RN Navigator Home Health Review
Overview
As an RN Navigator at Sigma Systems, Inc., you will monitor post-acute patients to ensure they meet CMS criteria for services, making recommendations to primary care providers. You will act as a patient advocate, coordinating care with post-acute facilities and clinic providers to optimize patient outcomes. This 3-month contract role is onsite in Irving, TX, with a Monday-to-Friday schedule. You will drive compliance, facilitate case conferences, and improve care transitions in a collaborative environment.
What You'll Do9
- 1Evaluate post-acute Home Health 485 forms for medical necessity and homebound status.
- 2Facilitate case conferences with post-acute agencies to assess patient progress and discharge plans.
- 3Recommend Home Health recertification or discharge based on CMS guidelines and patient assessments.
- 4Utilize MCG Guidelines to determine optimal type, frequency, and duration of care.
- 5Build strong relationships with post-acute agencies, primary care clinicians, and office staff.
- 6Ensure smooth care transitions by coordinating communication between Home Health agencies and PCP practices.
- 7Navigate electronic medical records and care management applications to document and track patient needs.
- 8Monitor program success metrics and provide feedback for improvement.
- 9Collaborate on discharge processes, performing outreach and documentation per CMS guidelines.
Requirements5
- 13 years of clinical experience required.
- 22 years of Home Health experience preferred.
- 33 years of managed care or care management experience preferred.
- 4Bachelor's degree in nursing preferred.
- 5Active RN license in the state of Texas.
Salary Insight
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