Job Information
Trinity Health MDMIA_Cancer Navigator RN_MOC0186 in DES MOINES, Iowa
Employment Type:
Full time
Shift:
Description:
ESSENTIAL FUNCTIONS:
· Coordinate patient care (scheduling, care transitions, communication, referrals for services), in collaboration with physicians and the broader care delivery team and across the continuum of care (oncology clinic offices, primary care clinic offices, palliative care, hospice, inpatient, ancillary services, and community resources).
i. Assess patients’ current and future needs across a broad spectrum of medical, psychosocial and financial aspects and make referrals to internal and external resources as appropriate.
ii. Serve as the primary point of contact between Cancer Resource Center resources and patients.
iii. Provide nursing care and guidance to the cancer patient from first contact and throughout follow-up – through the care continuum, serving as an essential link between patients and all other care providers, eliminating operational (i.e. scheduling, test results, etc.) barriers to service, and working closely with other health care disciplines to ensure timely appointments, results reporting, financial need referrals, communication, patient care and follow-up. May include accompanying patients to appointments (particularly if there are multiple barriers to care) and/or, providing clarification and literacy-level-appropriate education related to the visit.
iv. Visit new consults / referrals in a variety of settings (hospital, clinic, Cancer Resource Center) and facilitate continuing care within effective and realistic time frames.
v. Interface with other healthcare teams for appropriate referrals/services such as the social worker, pastoral care, dietician, dental hygienist, financial counselor, cancer rehabilitation, clinical research nurses, survivorship services, palliative care, hospice, smoking cessation, etc.
vi. Continually assess patients’ treatment progress and educational needs, working with the care team to make adjustments to care based on the assessment; consults with primary physician or designee and other members of the care delivery team as needed; refer to appropriate physicians, NPs or programs when needed.
vii. Maintain ongoing relationship with patients/families as they complete treatment.
viii. Facilitate financial assessment and referrals along with assisting with completing forms as needed.
ix. Facilitate language translation or interpretation services.
x. Facilitate transportation, lodging and/or child/elder care and addresses any other practical needs
xi. Build partnerships with local agencies and groups for community services referrals (e.g., referrals to other services and/or cancer survivor support groups).
xii. Facilitate distress screening and appropriate referrals. Assess for emotional well-being and make appropriate referrals as needed. Coordinate with available social work resources.
· Develop effective physician /cancer care team relationships
i. Communicate and collaborate with involved physicians and staff
members to facilitate individualized, holisitic patient care plan
ii. Facilitate communication between cancer care disciplines – surgical, medical, radiation oncology, pathology, radiology, other medical and surgical subspecialties.
iii. Maintain communication with patients, survivors, families, and the health care providers to monitor patient satisfaction with the cancer care experience.
iv. Ensure that navigator functions are meeting physician expectations and that navigator activities remain within scope of defined role.
· Provide patient and family education
i. Discuss physician visits with patients and families and assists to answer questions, in collaboration with treating physicians
ii. Reinforce education and instruction from physicians and other members of the care team.
iii. Provide anticipatory guidance related to the cancer journey for patients and families.
iv. In consultation with physicians on the case, answers questions from the patient/family pertaining to treatment, disease process, etc. and provide education on various diagnostic and treatment procedures to be done. Augment prescribed treatment plans as outlined by physicians on the case. Consult with physician regarding hospice, home health, palliative care, social service, nutritional and other support for patients.
· Document all patient coordination activities, education, and other interactions in designated inpatient and outpatient electronic health record systems to assure a timely, complete patient record and effective communication with other members of the care delivery team. Assist with tracking, documentation and outcome reporting for navigation services.
· Coordinate patient and family healthy living / survivorship programming and support groups for designated disease sites. Collaborate with other members of the care delivery team to develop and lead programming, including YMCA HLC Cancer Education Series, for individuals and groups on topics of prevention, detection, treatment, and strategies for dealing with the disease and with life in survivorship.
· Coordinate completion of treatment summaries and survivorship care plans for designated disease sites. Effectively utilize information system tools for creation and delivery of these summaries / plans to patients and other members of the care team.
· Assist physician moderators and MDC coordinator to facilitate multidisciplinary care conferences for designated disease sites. Assist with case finding for conferences, oversee creation of conference/case presentation summary documentation and delivery of documentation to medical record, primary care and specialty physicians.
· Active participant on the multidisciplinary care team and conferences, providing specific patient care information pertinent to the patient, follow up on patient care recommendations after the multidisciplinary conferences, and when necessary, facilitate the multidisciplinary conference.
· Plan and coordinate community screening activities and other community outreach / educational activities. Conduct health promotion and awareness programs and presentations in community as appropriate. Serve as a resource for and attend community health fairs and screenings.
· Serve as a liaison with community advocacy groups to promote Mercy Cancer Center (e.g., American Cancer Society, American Lung Association, Iowa Cancer Consortium). Represent Mercy Cancer Center in committees and activities of these groups.
· Assist with quality improvement efforts for designated disease sites (complete quality studies, set and monitor quality improvement goals, modify patient care protocols based on QI studies).
· Provide staff education (e.g., Ovarian Conference, symposiums).
· Support clinical research activity and accrual of patients to clinical research.
· Collaborate with clinical research nurses, facilitating patient referrals for potential clinical trial candidates, communicate patient care needs and schedule with the clinical trial nurse if patient accepted into a trial, negotiate patient care and teaching responsibilities with the clinical trial nurse when the patient is on a clinical trial
· Serve as a role model and mentor in promoting navigation concepts to Mercy Cancer Center, Mercy Medical Center, Mercy Health Network, general community, long term care facilities, and various clinics.
Additional Functions for Lung Navigator:
· Collaborate with others in the organization to develop and coordinate smoking cessation programs and resources. Serve as an advocate and educator for smoking prevention and cessation within the organization and in the community
· Develop and coordinate lung cancer screening program, and provide on going communication and coordination of lung cancer screening patients during the diagnostic phase through follow-up with serial diagnostic studies. Lead primary care physician communication and education efforts regarding lung cancer screening program.
MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:
· Registered nurse with valid license in State of Iowa required.
· Bachelor’s degree in healthcare field or actively pursuing. Must complete one class per semester.
· Twelve months of cancer related work experience required.
· Proof of completion of Mandatory Reporter abuse training specific to population served within three (3) months of hire.
· Excellent communication skills.
· Presentation skills with small and large groups, including mix of both public and professional audience.
· Valid Driver’s License required, must meet Mercy’s Motor Vehicle Safety Standards, must be at least 18 years of age and be eligible to drive per Iowa state law.
· May require travel to affiliate hospitals.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.
EOE including disability/veteran
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