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Highmark Health

Health insurance plans and wellness resources

Registered Nurse Navigator - Positive Health Clinic

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-timePittsburgh, PA, USANo salary listed

About the Job

Requirements

  • Current Pennsylvania registered nurse licensure or current multistate licensure through the enhanced Nurse Licensure Compact.
  • Bachelor's degree.
  • Current certification in the area of expertise is preferred.
  • A valid Pennsylvania driver's license is preferred.
  • Knowledge of the healthcare delivery system, resources, and community for the disease-site specialty, along with patient advocacy skills, is preferred.
  • American Heart Association CPR is required.
  • Act 34 Criminal Background Clearance Certificate is required.
  • Act 33 Child Abuse Clearance Certificate is required.
  • Act 73 FBI Fingerprinting Criminal Background Clearance Certificate is required.
  • Comply with HIPAA privacy requirements and company information-security guidelines when handling protected or confidential information.
  • Comply with the Code of Business Conduct, applicable laws and regulations, company policies, and training requirements.

Responsibilities

  • Serve as the consistent point of contact for referring physicians, patients, caregivers, families, and the community.
  • Facilitate patient flow by coordinating appointments and helping patients access clinical and supportive care services within the Network.
  • Coordinate all aspects of care with the multidisciplinary team for adult patients within the specialized disease state to ensure quality and comprehensive services.
  • Identify community needs and provide education, screening, support, referrals, care coordination, and other identified assistance.
  • Oversee community outreach, high-risk populations, and disease-specific sites to establish and sustain working relationships across the network, including with health plans, physicians, office staff, social services staff, and financial counselors.
  • Work with physician offices and facilities to identify at-risk patients and facilitate appropriate screening processes.
  • Travel to other facilities as required.
  • Educate patients and coordinate care regarding diagnoses, treatment options, courses of treatment, clinical-trial information, and available resources.
  • Work with the healthcare team to ensure safe handoffs and coordinate care between facilities and between inpatient and outpatient settings.
  • Identify families' bereavement needs and develop a plan of care when applicable.
  • Work with the Stroke Team to reduce readmissions.
  • Work with or assist Registry staff with data collection, patient outcomes, and updates to care-delivery models when applicable.
  • Coordinate appointments with the multidisciplinary team, including physicians, consults, and supportive-care services, and accompany patients to appointments as needed.
  • Ensure medication-adherence issues are addressed.
  • Track program data and outcomes, and identify gaps to improve patient care across the continuum.
  • Develop or attend an existing clinical-care conference to report on active patients to the multidisciplinary team.

Desired Qualifications

  • Certification in the area of expertise.
  • Valid Pennsylvania driver's license.
  • Knowledge of the healthcare delivery system, resources, and community for the disease-site specialty, along with patient advocacy skills.

About the Company

Highmark Health

Health insurance plans and wellness resources

Highmark Health provides health insurance plans in Pennsylvania, Delaware, and West Virginia for individuals, families, businesses, and Medicare beneficiaries. Plans are funded by premiums and government reimbursements, and cover services like doctor visits, hospital stays, prescription drugs, and preventive care, plus member tools such as symptom checkers, cost and coverage details, and OTC rapid test reimbursements. It differentiates itself through active community involvement and sustainability efforts, alongside a large, diverse member base and Medicare compatibility that influence plan design. The goal is to improve community health by offering comprehensive coverage and supportive health resources while operating in a responsible and sustainable way.

Company size
5,001-10,000
Company stage
Grant
Total funding
$29.6M
Headquarters
Pittsburgh, PA
Founded
1996

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