Nurse Navigator Risk and Quality

About Tufts Medicine:

Tufts Medicine is a leading integrated health system bringing together the best of academic and community healthcare to deliver exceptional, connected and accessible care experiences to consumers across Massachusetts. The health system is the principal teaching affiliate for Tufts University School of Medicine. The strong relationship between Tufts Medicine and Tufts University School of Medicine is evident in our governance, academic and research structure. Tufts Medicine is comprised of the following clinical entities:

* Tufts Medicine Professional Group (TMPG)

* Tufts Medicine Integrated Network (TMIN)

* Tufts Medical Center

* Lowell General Hospital

* MelroseWakefield Hospital, Lawrence Memorial Hospital of Medford

* Tufts Care at Home

Remote opportunity with occasional onsite travel to Tufts Medical Center, Lowell General Hsopital, MelroseWakefield Hospital and our Corporate Office in Burlington MA.

Hours: Full Time 40 hours between 8 AM - 5 PM

Job Overview

This position is responsible for ensuring timely and appropriate follow-up care for patients with outstanding imaging recommendations. Review patient records, analyze imaging results, and coordinate with providers and patients to facilitate completion of necessary follow-up, minimizing potential harm and improving patient outcomes.

Job Description

Minimum Qualifications:

1. Associate degree in Nursing.

2. Registered Nurse (RN) license.

3. Three (3) years of clinical nursing experience with two (2) years in acute care.

Preferred Qualifications:

1. Bachelor's degree in Nursing (BSN).

2. Experience in Oncology or Radiology nursing.

3. Experience with EPIC electronic health records system.

Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned.

1. Thoroughly review patient charts, including imaging reports, physician progress notes, laboratory and pathology results, and other relevant clinical documentation to identify actionable findings requiring follow-up.

2. Apply critical thinking and clinical judgment to determine the appropriate follow-up procedures and timelines for actionable findings identified in imaging exams. This includes assessing the urgency and nature of the findings and prioritizing cases accordingly.

3. Proactively communicate with ordering and follow-up providers and their staff members within and outside of the Tufts Medicine network to ensure timely completion of follow-up exams. This communication will be conducted via phone, fax, and electronic medical records (EMR).

4. Monitor and track responses from providers and staff. Escalate cases to management or the appropriate clinical leadership, when necessary, based on established protocols and nursing judgment, particularly in situations involving delays, non-responsiveness, or complex patient needs.

5. Accurately document all communications with providers, staff, and patients within the EPIC electronic medical record, ensuring accurate and comprehensive record-keeping.

6. Conduct a daily review of new overdue imaging cases and adhere to departmental procedures to ensure timely resolution of these cases. This includes initiating follow-up communication and escalating as needed.

7. Communicate with nursing leadership and other relevant clinical specialists regarding complex or challenging patient cases to ensure all ethical and legal considerations are addressed and appropriate care is provided.

8. Communicate with patients and their caregivers via phone to gather necessary information, provide nursing advice and education when appropriate within the scope of nursing practice, and connect patients with the necessary resources to facilitate completion of their required follow-up care.

9. Act as a patient advocate, assisting patients who encounter difficulties in reaching the appropriate provider or staff to initiate orders and schedule follow-up exams. This may involve problem-solving, navigating system barriers, and facilitating communication.

10. Provide education to patients regarding the importance of primary care, preventative screenings, and adherence to recommended follow-up care.

11. Educate patients on navigating the healthcare system, including scheduling appointments, understanding insurance coverage, and accessing available resources.

12. Communicate with Risk Management leadership to seek legal advice and guidance when indicated, particularly in situations involving potential liability or complex ethical dilemmas.

13. When applicable, perform nursing assessment and triage via phone if deemed necessary by nursing judgment and within the scope of the RN license, following established protocols and guidelines.

14. Maintain confidentiality and adhere to HIPAA regulations.

Physical Requirements:

1. Extensive use of computers and keyboards (typing).

2. Frequent use of telephones.

3. Ability to read and write in English.

Skills & Abilities:

1. Proficient computer skills, including electronic health records (EHR) systems, preferably EPIC.

2. Advanced critical thinking and clinical reasoning skills, with the ability to analyze complex medical information and make sound judgments.

3. Excellent communication skills (written and verbal), with the ability to effectively interact with patients, providers, and staff.

4. Strong organizational and time-management skills, with the ability to prioritize and manage multiple tasks efficiently.

5. Ability to work independently and as part of a team.

6. Ability to commitment to patient safety and quality of care.

Job Profile Summary

This role focuses on providing professional and nonprofessional nursing care services in accordance with physician orders. In addition, this role focuses on performing the following Nurse Navigator duties: Focuses on the patient's needs and helps guide the patient through the healthcare system and works to overcome obstacles that are in the way of the patient receiving the care and treatment they require. A professional individual contributor role that may direct the work of other lower level professionals or manage processes and programs. The majority of time is spent overseeing the design, implementation or delivery of processes, programs and policies using specialized knowledge and skills typically acquired through advanced education. A senior level role that requires advanced knowledge of job area typically obtained through advanced education and work experience. Typically responsible for: managing projects / processes, working independently with limited supervision, coaching and reviewing the work of lower level professionals, resolving difficult and sometimes complex problems.

Tufts Medicine is a leading integrated health system bringing together the best of academic and community healthcare to deliver exceptional, connected and accessible care experiences to consumers across Massachusetts. Comprised of Tufts Medical Center, Lowell General Hospital, MelroseWakefield Hospital, Lawrence Memorial Hospital of Medford, Care at Home - an expansive home care network, and large integrated physician network. We are an equal opportunity employer and value diversity and inclusion at Tufts Medicine. Tufts Medicine does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation by emailing us at careers@tuftsmedicine.org.