? Apply Now! Registered Nurse Navigator Home Health Review-Health Admin
Company: CHRISTUS Health
Location: Irving
Posted on: October 31, 2025
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Job Description:
Job Description Description Summary: The RN Navigator Home
Health Review monitors home health patients to ensure patients
continue to meet the CMS criteria for services. They are a member
of the patient’s care team and act as a patient advocate, providing
proactive outreach to CHRISTUS Health value-based payer patients.
The RN Navigator makes recommendations to primary care providers
regarding ongoing services. The RN Navigator facilitates
communication and coordinates care with physicians, the providers’
clinic, hospital facilities, family, caregivers, and other
community healthcare providers. The Associate will support
transitions of care as needed. Responsibilities: - Meets
expectations of the applicable OneCHRISTUS Competencies: Leader of
Self, Leader of Others, or Leader of Leaders. - Stays abreast of
current CMS and other payer guidelines for Home Health services. -
Receives and evaluates Home Health 485 form (Plan of Care) based on
Medical Necessity guidelines and Homebound Status requirements. -
Facilitates Case Conferences with Home Health Agencies for
evaluation of patient progress toward goals and discharge plan. -
Ensures Home Health agency is addressing the problem list and
providing appropriate follow up for patient needs. - Based on CMS
or other payer guidelines, patient assessment, and case
conferences, makes recommendation to PCP regarding Home Health
recertification or discharge from service. - Utilizes MCG
Guidelines for Home Care to optimize the type, frequency, and
duration of care. - Creates positive relationships with Home Health
agencies as well as Primary Care Clinicians and Office Staff. -
Ensures smooth transition of care along the continuum. -
Facilitates communication between Home Health agencies and PCP
practices as necessary to ensure patient's needs are addressed. -
Demonstrates expertise in navigating electronic medical record and
other care management applications. - Monitors key measures of
program success and provides feedback regarding opportunities to
improve. - Collaborates with team members in the discharge process,
performing outreach/documentation according to CMS guidelines and
the Population Health workflow. - Outreach to TOC patients should
focus on medication reconciliation/adherence, self-management, use
of personal health records, follow-up with PCPs/Specialists, and
review of indicators that a patient’s condition is worsening and
how to respond. - Promotes a positive work environment by
displaying a caring, sensitive approach to others, as evidenced by
listening, understanding, and responding to the needs of patients,
colleagues, and supervisors. - Performs other duties as assigned.
Job Requirements: Education/Skills - Bachelor’s Degree in Nursing
preferred. Experience - 3-5 years of clinical experience required.
- 2 years of Home health experience preferred. - 2-3 years of
managed care and/or care management experience preferred. Licenses,
Registrations, or Certifications - RN license in the state of
employment or compact is required. Work Schedule: 5 Days - 8 Hours
Work Type: Full Time
Keywords: CHRISTUS Health, Irving , ? Apply Now! Registered Nurse Navigator Home Health Review-Health Admin, Healthcare , Irving, Texas
