Oncology Nurse Navigator GI New Patient Referral Center

• : Inova’s mission is to provide world-class healthcare – every time, every touch – to each person in every community we have the privilege to serve.
  Inova is the only health system in the country where all 5 hospitals received five-star rankings from the Centers for Medicare and Medicaid Services; they are the only hospitals in the Washington, DC region to have earned the highest rating from the federal agency. Inova is home to prominent clinicians and scientists, who drive innovation to improve patient care, prevent disease and promote wellness.
  

Provides safe therapeutic care in a holistic and systematic way across the health system and continuum of care and in the community for past, current and potential cancer patients. Guides patient and family through the health system from diagnosis, testing, treatment and follow-up care to assist patients with navigating the continuum of care. Acts as a liaison, advocate and point of contact to patient/family members by helping them access the best healthcare outcomes from doctors, hospitals and others who provide their required services. May assist patients and families with resolving financial, psychosocial, functional, and administrative issues by advising of options and referring to appropriate resources. Acts as advisor/educator by providing emotional support, counseling, clinical education, resources and expert guidance to patients and families to promote their ability to understand and meaningfully participate in the healthcare process and personal decision-making. Facilitates and oversees the care delivery for patient under the direction of the department manager and in collaboration with the Life with Cancer Director.

Job Responsibilities

• Anticipates patient's needs and advocates for patient rights and appropriate utilization of services.
  • Offers individualized assistance to patients, families, and caregivers to help overcome health system barriers.
  • Develops and maintains effective liaison role between patient and attending, consulting other medical team members.
  • Acts as advisor/educator by providing emotional support, counseling, clinical education, resources and expert guidance to patients and families to promote their ability to understand and meaningfully participate in the healthcare process and personal decision-making.
  • Educates patient, family or caregiver(s), and members of the health care delivery team regarding treatment options, community resources, insurance benefits, self-care management, etc. to facilitate timely and informed decision-making throughout all phases of the treatment/disease continuum process. Encourages and coaches patients to be engaged in their care planning and to embrace their essential role in the decision making process.

• Conducts ongoing promotion of healthcare program to community based resources to include developing written materials and public presentations describing activities related to patient care and research.
  • Co-facilitates at least one disease specific support group in area of expertise and participates in community outreach opportunities related to cancer care, as relevant.

• Serves as a clinical consultant to the health care team. Assesses patient needs and coordination of multidisciplinary care.
• Creates and maintains transplant calendar.
  • Facilitates assessment of patient appropriateness for transplantation.
  • Coordinates pre-transplant evaluation and disease re-staging, based on diagnosis, to determine appropriate timing to proceed with transplant.
  • Collects and reviews all pre-transplant clinical data to summarize and highlight potential points of issue for physician review.
  • Assesses patient needs and dynamically collaborate with other members of the health-care team to address actual and potential problems and provide direction for their resolution.
  • Verifies with Transplant Financial Coordinator benefits for stem cell transplantation and need for authorization for any pre transplant testing.
  • Participates in transplant insurance company site visits and all program specific transplant collaborative practice committees.

• Completes documentation related to pretesting, plan, written consent, orders and outcome according to policy; communicate verbally or in writing to other team members.
  • Coordinates the health care team to implement the plan of care.
  • Keeps team members informed of patient progress/changes.

• Coordinates patient discharge from hospital to insure adherence to SOPs.
  • Facilitates smooth transition from inpatient services to outpatient clinic.

• Performs stem cell infusions according to program SOPs and hospital policies.
  • Identifies, trains, and maintains competency documentation for back-up infuser RNs.

• Builds working relationships with patient, healthcare providers, and community resources to maximize patient outcome and identify/resolve barriers to the plan of care.
• Conducts comprehensive assessment of the patient's health and psycho-social needs, and develops a case management plan in collaboration with the patient and their support system.
  • Collaborates with multidisciplinary team to address patient questions and responses about the care process and treatment options.
  • Collaborates with the interdisciplinary team and incorporates the expertise of the team to achieve desired patient outcomes.
  • Respects and has an understanding of other clinical disciplines.

• Communicates with payers to facilitate covered day reimbursement certification for assigned patients.
  • Discusses payer criteria and issues on a case-by-case basis with clinical staff and follows up to resolve problems with payors as needed.

• Communicates effectively and works collaboratively and cooperatively with others.
  • Demonstrates respect and understanding of other clinical disciplines and uses and integrated approach to achieve desired patient outcomes.
  • Participates in weekly team review of transplant patients.
  • Participates in monthly quality assurance meetings. Facilitates communication among departments to ensure continuity of care. Establishes and cultivates relationships with physicians and health care team members. Demonstrates effective communication skills and assists in the resolution of conflict among health care team members, patients and families.

• Uses an integrated approach to patient outcomes.
  • Maintains collaborative professional working relationships with clinicians and administrative staff necessary to develop and implement a successful system-wide management of cancer population and program activities.
  • Develops and maintains effective liaison role between patient and attending, consulting and other medical team members.
  • Focuses on contributing information regarding the availability of community based resources.
  • Demonstrates proficiency in the referral process and use of the multidisciplinary resources to meet patient needs; maintains culturally sensitive channels of communication at all times.
  • Facilitates the assessment of patients learning needs and outcomes measures of patient education, accesses resources from all disciplines to achieve patient outcomes.
  • Provides patient and family members with appropriate education and materials as well as treatment guidelines and management of symptoms and side effects of treatment.
  • Seeks to improve healthcare experience and positive patient outcome.
  • Assists with patient's satisfaction with the integrated health care delivery model and access to appropriate care or facility.

• Promotes lifelong learning and evidence-based practice by self and others to improve the care of patients with past, current, or potential diagnosis of cancer.
• Provides personal, single point of contact for patients and their family, provides referrals to support and ancillary services as needed, and ensures patient has appropriate access to health care services and providers.
• Develops and administers all aspects of the Transplant Program's performance improvement program.
  • Works with transplant team, establishes quality goals and identifies performance and quality improvement initiatives. Implements data collection and review methodologies.
  • Performs analysis of data for the performance improvement program.
  • Monitors and reports quality and performance improvement data to the transplant team, hospital quality structure and regulatory bodies as required.
  • Facilitates program adverse event review and reporting.
  • Participates in organ specific protocol development and variance analysis.
  • Educates patient, family and care providers.
  • Plans, implements and evaluates formal and informal education regarding all aspects of care for the patient, family and caregivers and documents according to established policy.
  • Maintains a working knowledge of availability of community resources and financial services for providing clinical care and knowledge about appropriate referrals.
  • Conducts comprehensive assessments of patients to include psycho-social, psycho-educational, physical, and spiritual assessments.
  • Utilizes the nursing process, provides education and resources to facilitate informed decision making and timely access to quality health and psycho-social care throughout all phases of the continuum process.
  • Offers individualized assistance to patients, families, and caregivers to help overcome health system barriers.
  • Plans, implements and evaluates formal and informal education regarding all aspects of care for the patient, family and caregivers and documents according to established policy.
  • Assess and utilize resources from all disciplines to meet patient and family educational needs and improve patient outcomes.
    • Serve as an onsite clinical resource and mentor to all nursing staff involved in the care of transplant patients.
    • Effectively develops and manages patient navigator programs for the cancer population, family members, and the community.
      • Develops and implements a culturally appropriate, trans-disciplinary plan for patients seeking treatment by facilitating appointment scheduling, assisting with referral process, and/or providing information, education, and advocacy to patients throughout the care process.
      • Collaborates with multidisciplinary team to discuss treatment options and patient's response to those options (ie Tumor Board, Cancer Committee).
      • Promotes and provides patient, family, staff, and community education through the utilization of expert clinical knowledge base.
      • Works in partnership with community-based organizations to improve the continuum of care for those affected by cancer. Submits monthly statistics, reports, and program activities 100% of the time.
      • Eliminates barriers to patient's access to health care services and facilitates continuity of care/care coordination.
      • Maintains cultural competence in order to ensure coordination of care for patients happens in a timely manner, they receive access to resources throughout the continuum, and they follow through with recommendations from the health care team.
      • Develops/maintains reliable systems to document, track and monitor patient data.
      • Demonstrates proficiency with caseload assignment and ability to manage complex cases effectively.
      • Provides formal and informal educational programs to improve staff knowledge and improve quality of care.
      • Identifies ongoing educational needs and actively seeks out and participates in educational programs to enhance knowledge and skill base.
        • Ensures improvement in practice by assuming responsibility for self-development and lifelong learning.
        • Obtains/maintains professional certifications.
        • Ensures improvements in practice settings by assuming responsibility for self-development in life-long learning.
        • Provides direction and guidance to others regarding practice, serves as a resource.
          • Shows leadership skills demonstrated in decision making and problem solving.
          • Seeks opportunities to demonstrate leadership within the health care team as well as the Inova Health System.
          • Serves as a clinical consultant to the health care team.
          • Collaborates in the development and implementation of educational resources and presentations for the cancer population.

• Reviews self development plan and professional goals; seeks new knowledge toward the progression of professional goals.
  • Promotes lifelong learning and evidence-based practice, by self and others, to improve the care of patients with past, current, or potential diagnosis of cancer.

• Coordinates a patient's plan of care which may include answering patient questions regarding disease process and plan of care, appointment scheduling when appropriate, assisting with referral process, and providing community resources.
  • Provides educational information and advocacy to patient throughout care process in accordance with service line policies and procedures.
  • Functions as a contact to internal and external community/family services for patients in need of services such as screening, diagnostic treatment, clinical research participation, support services, and follow-up/aftercare plan.
  • Refers cases to the appropriate resources for assistance.
  • Creates a seamless flow through the health system to facilitate the patient's care. Incorporates data and information to continuously improve care and practice.

• Organizes and submits data to ensure compliance with regulatory guidelines.
  • Identifies and documents variances from SOPs.
  • Presents the results in monthly meeting for team review.
  • Maintains entry, review and validation of all required data including engraftment documentation, 30-day review, etc.
  • Performs formal clinical audits per policy.
  • Participates in quality improvement initiatives and assists with process and protocol development/revision based on evidence based/best practice findings. Maintains current knowledge of all regulatory requirements for hospitals and organ transplant programs.
  • Coordinates continuous survey readiness activities.
  • Monitors compliance with all CMS, UNOS and JCAHO requirements. Assists in RFI completion.
  • Represents transplant programs in appropriate hospital quality activities and committees.

• Obtains appropriate continuing education to maintain and improve knowledge of regulatory requirements and quality improvement tools and techniques.
• Educates patients and family members regarding disease process.
• Maintains a working knowledge of availability of community resources and financial services for providing clinical care and knowledge about appropriate referrals.
• Utilizes standards, guidelines, and protocols for determination of care needs.
• Coordinates community health programs and cancer-related education and groups.
• Incorporates data and information to continuously improve services and practice to enhance outcomes.Participates in the development of outcomes measures as well as surveys regarding patient satisfaction with the services received, services provided, and the impact of patient education.
• Supports a smooth transition of patients from active treatment into survivor ship or end-of-life care.
  • Uses an ethical framework regarding patient care to assist cancer patients with issues related to treatment goals, advance directives, palliative care, and end-of-life concerns.
  • Participates in the broad management for cancer services by coordinating cancer-related health programs, education, and groups, if applicable.
    

Requirements

Mon-Fri day shift

3 to 5 years' progressive clinical nursing with primary care management of patient population

BSN

Current Basic Life Support (BLS) and
Certification in oncology within 2 years of employment.

Strong oncology knowledge; Basic knowledge of managed care; Working knowledge of insurance coverage and procedures; Working knowledge of community resources; understanding of health care facilities and processes; Strong ve

Verrbal and written communication skills; Strong interpersonal skills; Proficient computer skills

For Internal use: IND1 #LI-AM1

• : Inova’s mission is to provide world-class healthcare – every time, every touch – to each person in every community we have the privilege to serve.
  Inova is the only health system in the country where all 5 hospitals received five-star rankings from the Centers for Medicare and Medicaid Services; they are the only hospitals in the Washington, DC region to have earned the highest rating from the federal agency. Inova is home to prominent clinicians and scientists, who drive innovation to improve patient care, prevent disease and promote wellness.
  

Provides safe therapeutic care in a holistic and systematic way across the health system and continuum of care and in the community for past, current and potential cancer patients. Guides patient and family through the health system from diagnosis, testing, treatment and follow-up care to assist patients with navigating the continuum of care. Acts as a liaison, advocate and point of contact to patient/family members by helping them access the best healthcare outcomes from doctors, hospitals and others who provide their required services. May assist patients and families with resolving financial, psychosocial, functional, and administrative issues by advising of options and referring to appropriate resources. Acts as advisor/educator by providing emotional support, counseling, clinical education, resources and expert guidance to patients and families to promote their ability to understand and meaningfully participate in the healthcare process and personal decision-making. Facilitates and oversees the care delivery for patient under the direction of the department manager and in collaboration with the Life with Cancer Director.

Job Responsibilities

• Anticipates patient's needs and advocates for patient rights and appropriate utilization of services.
  • Offers individualized assistance to patients, families, and caregivers to help overcome health system barriers.
  • Develops and maintains effective liaison role between patient and attending, consulting other medical team members.
  • Acts as advisor/educator by providing emotional support, counseling, clinical education, resources and expert guidance to patients and families to promote their ability to understand and meaningfully participate in the healthcare process and personal decision-making.
  • Educates patient, family or caregiver(s), and members of the health care delivery team regarding treatment options, community resources, insurance benefits, self-care management, etc. to facilitate timely and informed decision-making throughout all phases of the treatment/disease continuum process. Encourages and coaches patients to be engaged in their care planning and to embrace their essential role in the decision making process.

• Conducts ongoing promotion of healthcare program to community based resources to include developing written materials and public presentations describing activities related to patient care and research.
  • Co-facilitates at least one disease specific support group in area of expertise and participates in community outreach opportunities related to cancer care, as relevant.

• Serves as a clinical consultant to the health care team. Assesses patient needs and coordination of multidisciplinary care.
• Creates and maintains transplant calendar.
  • Facilitates assessment of patient appropriateness for transplantation.
  • Coordinates pre-transplant evaluation and disease re-staging, based on diagnosis, to determine appropriate timing to proceed with transplant.
  • Collects and reviews all pre-transplant clinical data to summarize and highlight potential points of issue for physician review.
  • Assesses patient needs and dynamically collaborate with other members of the health-care team to address actual and potential problems and provide direction for their resolution.
  • Verifies with Transplant Financial Coordinator benefits for stem cell transplantation and need for authorization for any pre transplant testing.
  • Participates in transplant insurance company site visits and all program specific transplant collaborative practice committees.

• Completes documentation related to pretesting, plan, written consent, orders and outcome according to policy; communicate verbally or in writing to other team members.
  • Coordinates the health care team to implement the plan of care.
  • Keeps team members informed of patient progress/changes.

• Coordinates patient discharge from hospital to insure adherence to SOPs.
  • Facilitates smooth transition from inpatient services to outpatient clinic.

• Performs stem cell infusions according to program SOPs and hospital policies.
  • Identifies, trains, and maintains competency documentation for back-up infuser RNs.

• Builds working relationships with patient, healthcare providers, and community resources to maximize patient outcome and identify/resolve barriers to the plan of care.
• Conducts comprehensive assessment of the patient's health and psycho-social needs, and develops a case management plan in collaboration with the patient and their support system.
  • Collaborates with multidisciplinary team to address patient questions and responses about the care process and treatment options.
  • Collaborates with the interdisciplinary team and incorporates the expertise of the team to achieve desired patient outcomes.
  • Respects and has an understanding of other clinical disciplines.

• Communicates with payers to facilitate covered day reimbursement certification for assigned patients.
  • Discusses payer criteria and issues on a case-by-case basis with clinical staff and follows up to resolve problems with payors as needed.

• Communicates effectively and works collaboratively and cooperatively with others.
  • Demonstrates respect and understanding of other clinical disciplines and uses and integrated approach to achieve desired patient outcomes.
  • Participates in weekly team review of transplant patients.
  • Participates in monthly quality assurance meetings. Facilitates communication among departments to ensure continuity of care. Establishes and cultivates relationships with physicians and health care team members. Demonstrates effective communication skills and assists in the resolution of conflict among health care team members, patients and families.

• Uses an integrated approach to patient outcomes.
  • Maintains collaborative professional working relationships with clinicians and administrative staff necessary to develop and implement a successful system-wide management of cancer population and program activities.
  • Develops and maintains effective liaison role between patient and attending, consulting and other medical team members.
  • Focuses on contributing information regarding the availability of community based resources.
  • Demonstrates proficiency in the referral process and use of the multidisciplinary resources to meet patient needs; maintains culturally sensitive channels of communication at all times.
  • Facilitates the assessment of patients learning needs and outcomes measures of patient education, accesses resources from all disciplines to achieve patient outcomes.
  • Provides patient and family members with appropriate education and materials as well as treatment guidelines and management of symptoms and side effects of treatment.
  • Seeks to improve healthcare experience and positive patient outcome.
  • Assists with patient's satisfaction with the integrated health care delivery model and access to appropriate care or facility.

• Promotes lifelong learning and evidence-based practice by self and others to improve the care of patients with past, current, or potential diagnosis of cancer.
• Provides personal, single point of contact for patients and their family, provides referrals to support and ancillary services as needed, and ensures patient has appropriate access to health care services and providers.
• Develops and administers all aspects of the Transplant Program's performance improvement program.
  • Works with transplant team, establishes quality goals and identifies performance and quality improvement initiatives. Implements data collection and review methodologies.
  • Performs analysis of data for the performance improvement program.
  • Monitors and reports quality and performance improvement data to the transplant team, hospital quality structure and regulatory bodies as required.
  • Facilitates program adverse event review and reporting.
  • Participates in organ specific protocol development and variance analysis.
  • Educates patient, family and care providers.
  • Plans, implements and evaluates formal and informal education regarding all aspects of care for the patient, family and caregivers and documents according to established policy.
  • Maintains a working knowledge of availability of community resources and financial services for providing clinical care and knowledge about appropriate referrals.
  • Conducts comprehensive assessments of patients to include psycho-social, psycho-educational, physical, and spiritual assessments.
  • Utilizes the nursing process, provides education and resources to facilitate informed decision making and timely access to quality health and psycho-social care throughout all phases of the continuum process.
  • Offers individualized assistance to patients, families, and caregivers to help overcome health system barriers.
  • Plans, implements and evaluates formal and informal education regarding all aspects of care for the patient, family and caregivers and documents according to established policy.
  • Assess and utilize resources from all disciplines to meet patient and family educational needs and improve patient outcomes.
    • Serve as an onsite clinical resource and mentor to all nursing staff involved in the care of transplant patients.
    • Effectively develops and manages patient navigator programs for the cancer population, family members, and the community.
      • Develops and implements a culturally appropriate, trans-disciplinary plan for patients seeking treatment by facilitating appointment scheduling, assisting with referral process, and/or providing information, education, and advocacy to patients throughout the care process.
      • Collaborates with multidisciplinary team to discuss treatment options and patient's response to those options (ie Tumor Board, Cancer Committee).
      • Promotes and provides patient, family, staff, and community education through the utilization of expert clinical knowledge base.
      • Works in partnership with community-based organizations to improve the continuum of care for those affected by cancer. Submits monthly statistics, reports, and program activities 100% of the time.
      • Eliminates barriers to patient's access to health care services and facilitates continuity of care/care coordination.
      • Maintains cultural competence in order to ensure coordination of care for patients happens in a timely manner, they receive access to resources throughout the continuum, and they follow through with recommendations from the health care team.
      • Develops/maintains reliable systems to document, track and monitor patient data.
      • Demonstrates proficiency with caseload assignment and ability to manage complex cases effectively.
      • Provides formal and informal educational programs to improve staff knowledge and improve quality of care.
      • Identifies ongoing educational needs and actively seeks out and participates in educational programs to enhance knowledge and skill base.
        • Ensures improvement in practice by assuming responsibility for self-development and lifelong learning.
        • Obtains/maintains professional certifications.
        • Ensures improvements in practice settings by assuming responsibility for self-development in life-long learning.
        • Provides direction and guidance to others regarding practice, serves as a resource.
          • Shows leadership skills demonstrated in decision making and problem solving.
          • Seeks opportunities to demonstrate leadership within the health care team as well as the Inova Health System.
          • Serves as a clinical consultant to the health care team.
          • Collaborates in the development and implementation of educational resources and presentations for the cancer population.

• Reviews self development plan and professional goals; seeks new knowledge toward the progression of professional goals.
  • Promotes lifelong learning and evidence-based practice, by self and others, to improve the care of patients with past, current, or potential diagnosis of cancer.

• Coordinates a patient's plan of care which may include answering patient questions regarding disease process and plan of care, appointment scheduling when appropriate, assisting with referral process, and providing community resources.
  • Provides educational information and advocacy to patient throughout care process in accordance with service line policies and procedures.
  • Functions as a contact to internal and external community/family services for patients in need of services such as screening, diagnostic treatment, clinical research participation, support services, and follow-up/aftercare plan.
  • Refers cases to the appropriate resources for assistance.
  • Creates a seamless flow through the health system to facilitate the patient's care. Incorporates data and information to continuously improve care and practice.

• Organizes and submits data to ensure compliance with regulatory guidelines.
  • Identifies and documents variances from SOPs.
  • Presents the results in monthly meeting for team review.
  • Maintains entry, review and validation of all required data including engraftment documentation, 30-day review, etc.
  • Performs formal clinical audits per policy.
  • Participates in quality improvement initiatives and assists with process and protocol development/revision based on evidence based/best practice findings. Maintains current knowledge of all regulatory requirements for hospitals and organ transplant programs.
  • Coordinates continuous survey readiness activities.
  • Monitors compliance with all CMS, UNOS and JCAHO requirements. Assists in RFI completion.
  • Represents transplant programs in appropriate hospital quality activities and committees.

• Obtains appropriate continuing education to maintain and improve knowledge of regulatory requirements and quality improvement tools and techniques.
• Educates patients and family members regarding disease process.
• Maintains a working knowledge of availability of community resources and financial services for providing clinical care and knowledge about appropriate referrals.
• Utilizes standards, guidelines, and protocols for determination of care needs.
• Coordinates community health programs and cancer-related education and groups.
• Incorporates data and information to continuously improve services and practice to enhance outcomes.Participates in the development of outcomes measures as well as surveys regarding patient satisfaction with the services received, services provided, and the impact of patient education.
• Supports a smooth transition of patients from active treatment into survivor ship or end-of-life care.
  • Uses an ethical framework regarding patient care to assist cancer patients with issues related to treatment goals, advance directives, palliative care, and end-of-life concerns.
  • Participates in the broad management for cancer services by coordinating cancer-related health programs, education, and groups, if applicable.
    

Requirements

Mon-Fri day shift

3 to 5 years' progressive clinical nursing with primary care management of patient population

BSN

Current Basic Life Support (BLS) and
Certification in oncology within 2 years of employment.

Strong oncology knowledge; Basic knowledge of managed care; Working knowledge of insurance coverage and procedures; Working knowledge of community resources; understanding of health care facilities and processes; Strong ve

Verrbal and written communication skills; Strong interpersonal skills; Proficient computer skills

For Internal use: IND1 #LI-AM1