Nurse Navigator  

The Nurse Navigator is a registered nurse who serves as the central point of contact for patients and families moving through the care continuum. The Navigator identifies and removes clinical, financial, logistical, and psychosocial barriers to timely care; coordinates appointments, testing, and referrals across providers and settings; and provides education and support from initial contact through treatment and follow-up.

Working within a multidisciplinary team, the Navigator promotes continuity of care, improves patient understanding of the treatment plan, supports adherence, and contributes to reduced avoidable emergency department visits and readmissions. The role blends direct patient interaction, care coordination, and program-level quality work.

Patient Navigation and Care Coordination

• Serve as the consistent, identified point of contact for assigned patients and their caregivers across the episode of care.

• Conduct initial and ongoing assessments to identify clinical, financial, transportation, language, health literacy, cultural, and psychosocial barriers to care.

• Track pending results and outstanding orders; ensure findings are communicated to the ordering provider and, as appropriate, to the patient.

Patient Education and Support

• Provide evidence-based education on diagnosis, treatment options, medications, self-management, symptom monitoring, and warning signs requiring escalation.
• Deliver education at an appropriate health literacy level and in the patient's preferred language, using interpreter services when needed.
• Support shared decision-making by helping patients formulate questions, understand options, and communicate their goals and preferences to the care team.
• Provide emotional support and reinforce coping strategies; recognize distress and refer to social work, behavioral health, chaplaincy, or community resources.
• Connect patients to financial counseling, insurance and prior authorization assistance, prescription assistance programs, transportation, nutrition support, and other community resources.
• Educate patients on advance care planning and advance directives where appropriate.

Documentation, Quality, and Program Development

• Document all navigation activities, assessments, interventions, communications, and outcomes accurately and timely in the electronic health record.
• Collect and report navigation metrics — for example, time to treatment, barriers identified and resolved, no-show rates, patient volume, and patient satisfaction.
• Participate in quality improvement initiatives, process improvement projects, and accreditation or certification survey readiness.
• Contribute to the development of navigation protocols, pathways, patient education materials, and standard work.
• Participate in community outreach, screening events, and education programs as assigned.

• Professionally Registered Nurse with experience in patient education and navigation
• Strong analytical and planning skills;
• Good communication and presentation skills;
• Excellent problem-solving skills;
• Adherence to ethical principles and standards of nursing practice;
• Commitment to ongoing professional development and staying current with medical knowledge and nursing best practices.