Nursing Jobs in Rumson, NJ
$84,783 - $131,414 / year
Department/Unit: HBD - Maternal-Fetal Practice Work Shift: Day (United States of America) Salary Range: $84,783.00 - $131,414.00 The Nurse Navigator is a registered nurse who serves as the primary point of contact for patients across the ambulatory care continuum. This role coordinates patient care across specialties and guides patients through complex treatment pathways, from diagnosis through treatment and follow-up. The Nurse Navigator focuses on care coordination, patient advocacy, and program support, ensuring timely access to care, reducing barriers, and enhancing patient outcomes and experience. This role supports multidisciplinary care delivery and specialty program requirements, including accreditation standards. Essential Duties and Responsibilities: Care Coordination & Navigation Serve as the primary point of contact for assigned patients across the care continuum Coordinate care across specialties including consults, diagnostics, procedures, and follow-ups Facilitate the appropriate and efficient delivery of healthcare services within and across systems by assessing patient needs and matching unmet needs with appropriate referrals and support services Track patient progression through care pathways and ensure completion of recommended care plans Proactively identify delays or gaps in care and intervene to maintain timely progression Care Coordination & Multidisciplinary Collaboration Participate in the coordination of care with the multidisciplinary team, promoting timely follow-up of treatment and supportive care recommendations Collaborate with physicians, APPs, nursing, social work, and ancillary services to ensure coordinated care delivery Collaborate with healthcare team members to build partnerships with community agencies and local organizations that support patient care, education, and psychosocial needs Participate in case discussions and program-based care planning Transitions of Care Support patients transitioning between care settings (hospital, outpatient, specialty services) Conduct post-discharge outreach and coordinate follow-up care Reinforce discharge instructions and ensure continuity of care Access & Patient Advocacy Act as a patient advocate by facilitating timely scheduling of appointments, diagnostic testing, and procedures to support the plan of care and promote continuity Expedite care when clinically appropriate to reduce delays in diagnosis and treatment Ensure patients understand next steps and assist in navigating the healthcare system Patient Education Assess, provide, and reinforce educational needs of patients, families, and caregivers, taking into consideration barriers to learning such as health literacy, language, and cultural factors Provide disease-specific education related to diagnosis, treatment options, procedures, and supportive care Reinforce provider education and ensure patient understanding of the care plan Program/ Service Line Support Support multidisciplinary care pathways across specialty programs (e.g., bariatrics, breast surgery) Participate in program development and workflow optimization Assist in maintaining compliance with program standards and accreditation requirements Collaborate with program teams to ensure efficient and coordinated care delivery Patient Tracking & Registry Management Maintain patient registries and tracking systems for program populations Monitor patient progression through care pathways and identify gaps Ensure follow-up on missed appointments or incomplete care steps Documentation & EHR Utilization Document all patient interactions and coordination activities in the EHR Ensure timely and accurate communication across the care team Quality Improvement & Accreditation Support Support quality improvement initiatives related to access, care coordination, and patient outcomes Assist with data tracking and reporting for program performance Support accreditation requirements for specialty programs (e.g., MBSAQIP, NAPBC) Ensure adherence to standardized care pathways and regulatory expectations Leadership & Mentorship Provide informal guidance and support to clinical and administrative staff related to care coordination workflows Serve as a resource for navigation processes and patient flow Participate in team-based problem solving and process improvement This role does not typically include formal leadership responsibilities Clinical Knowledge & Standards Demonstrate knowledge of evidence-based clinical guidelines and standards (e.g., NCCN, Commission on Cancer [CoC], and specialty-specific program requirements) Apply guideline-based knowledge to support patient navigation, education, and care coordination Maintain awareness of available specialty and community resources to support patients throughout the disease process Understanding of disease-specific care pathways relevant to assigned specialty programs Familiarity with accreditation standards and program requirements (e.g., Obstetrics, Gynecology, Maternal Fetal Medicine, Gynecologic Oncology, Urogynecology, Family Planning) Knowledge of care coordination best practices and ambulatory workflows Qualifications: Associate's Degree in Nursing - required Bachelor's Degree in Nursing (BSN) - preferred 3-5 years clinical nursing experience - required Experience in ambulatory care, specialty care, or care coordination preferred Strong clinical assessment and triage skills Excellent communication and patient education abilities Proficiency with electronic health records (Epic preferred) Experience supporting specialty programs (e.g., Obstetrics, Gynecology, Maternal Fetal Medicine, Gynecologic Oncology, Urogynecology, Family Planning) RN - Registered Nurse - State Licensure and/or Compact State Licensure for New York State - required Equivalent combination of relevant education and experience may be substituted as appropriate. Thank you for your interest in Albany Med Health System! Albany Med Health System is an equal opportunity employer. This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification. 
$90,000 - $110,000 / year
Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Even in a non-clinical role, employees have an opportunity to make a positive impact on the quality of our health plan members' lives. The MJHS Difference At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve. Benefits include: Sign-on Bonuses OR Student Loan Assistance for clinical staff FREE Online RN to BSN and MSN degree programs! Tuition Reimbursement for all full and part-time staff Dependent Tuition Reimbursement for clinical staff! Generous paid time off, including your birthday! Affordable and comprehensive medical, dental and vision coverage for employee and family members Two retirement plans ! 403(b) AND Employer Paid Pension Flexible spending And MORE! MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF) Responsibilities The position requires the registered nurse to perform case reviews and process all requests for elective services and durable medical equipment in accordance with the Center for Medicare and Medicaid Guidelines, New York State Medicaid Guidelines, evidence-based Best Practice Guidelines, as well as other departmental criteria and protocols. Works collaboratively with other disciplines within and outside of the department including Physician Advisors, Vendors, Providers, Member’s Primary Care Physicians, and other Specialists as necessary to ensure compliance with regulatory standards and timely provision of services. The registered Nurse will provide high-quality customer service. Qualifications Graduate of an accredited Nursing Program. Bachelors preferred. Current New York State RN License required. A minimum of two years of clinical experience is preferred; relevant managed care healthcare experience may be considered in lieu of clinical nursing experience. Knowledge of Utilization management processes is required. Prior managed care experience is required. Working knowledge of Medicare and Medicaid regulations is required. Knowledge of current standards of medical practice and healthcare delivery systems. Working knowledge of Windows, Word, and Excel. Excellent written and oral communication skills. Ability to manage multiple priorities, effective organizational, and time management skills. Good analytic abilities. Min USD $90,000.00/Yr. Max USD $110,000.00/Yr. 
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