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Highmark Health

Health insurance plans and wellness resources

RN Nurse Navigator

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

About the Job

Requirements

  • Current Pennsylvania registered nurse licensure or current multistate licensure through the enhanced Nurse Licensure Compact is required.
  • One to three years of nursing experience in the specialty is required.
  • Certification in the area of expertise is preferred.
  • Current American Heart Association cardiopulmonary resuscitation qualification is required.
  • Act 34 Criminal Background Clearance Certificate is required.
  • Act 33 Child Abuse Clearance Certificate is required.
  • Act 73 Federal Bureau of Investigation fingerprinting criminal background clearance certificate is required.
  • A valid Pennsylvania driver's license may be required.
  • Older Adults Protective Services Act clearance may be required depending on location.
  • Employees must comply with the Health Insurance Portability and Accountability Act, company privacy policies and procedures, information security guidelines, the Code of Business Conduct, applicable laws and regulations, and company 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 for adult patients within a specialized disease state in collaboration with the multidisciplinary team to ensure quality and comprehensive services.
  • Identify community needs and provide education, screening, support, referrals, care coordination, and other assistance as needed.
  • 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, financial counselors, and dieticians.
  • Educate patients and coordinate care regarding diagnoses, treatment options, courses of treatment, clinical trial information, and available resources.
  • Work with the health care team to ensure safe handoffs and coordination of care between facilities and between inpatient and outpatient settings; work with high-risk care teams to reduce readmissions.
  • Work with or assist registry staff with data collection, patient outcomes, and updates to care delivery models, as applicable.
  • Coordinate multidisciplinary appointments and accompany patients to appointments as needed; ensure medication adherence issues are addressed.
  • Work with physician offices and facilities to identify at-risk patients and facilitate appropriate screening processes.
  • 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 active patients to the multidisciplinary team.
  • Identify bereavement needs of families and develop a plan of care, as applicable.
  • Perform other assigned or required duties.

Desired Qualifications

  • Bachelor's degree in Nursing.

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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