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The Care Navigator RN Clinical Educator plans, directs, coordinates, evaluates, develops, and/or delivers training and education programs for professional nursing personnel. The Care Navigator RN Clinical Educator work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
Job Description
The Care Navigator RN Educator works within the Clinical Education team and is focused on training and educating clinical staff that support our PCO centers, focused on RN Care Navigators.
Working within an interdisciplinary care team, the RN Care Navigator is responsible for proactively engaging patients identified as high-risk and implementing targeted interventions to address multi-complexity medical and social needs and increase access to care. The RN Care Navigator will provide guidance and oversight of care coordination efforts to other members of the team, and handle clinical escalations as indicated.
The Care Navigator RN Educator has a deep understanding of all the High-Risk Patient Management (HRPM), Transitional Care Management (TCM) program, and STARS quality measures to ensure that care integration staff can apply value-based care and population health principles effectively within their daily work. This knowledge enables the Care Navigator RN Educator to gain the respect and confidence of their peers as a peer educator.
Primary Responsibilities :
Develop, plan, organize, and supervise training for RN Care Navigators, care integration team members and primary care providers including principles of population health, value-based care, and senior care. Oversee training aspects of STARS Quality metrics, readmission risk, Chronic Disease Management, Medication Reconciliation, Care Giver Burnout, Advance Care Planning, and Suicide. May also need to incorporate EMR and systems training, Compliance, primary care policy and procedure, coding and documentation, quality, utilization, customer service standards, team effectiveness and communication as needed. Training could occur in-person in markets and virtually through live and recorded sessions.
Serve as faculty for clinical staff learning journeys and provider onboarding as needed.
Have knowledge on transitions of care best practices, creation and management of care plans, knowledge on 5M Geriatric best practices. Have strong Motivation Interviewing (MI) skills and be able to teach and facilitate sessions on how to gain these skillsets.
Monitor medical performance through direct observation, listening to calls, chart review, data review, and provide guidance to ensure that the quality of care being provided meets appropriate standards and to ensure cost-effective utilization practices for new and current associates that require coaching or performance improvement plans.
Supports the development of score cards to document Care Navigator work quality and completes score cards through direct observation, chart review and shares such data with education team, care integration team and other stakeholders on a regular basis. Supports preceptors and preceptor program to ensure smooth transition for new associates between national and market-based onboarding.
Ensure licensed RNs meet competency requirements and assign modules for those who need education and training, in addition to shadowing and hands on work.
Work collaboratively with Regional Directors, Program Delivery team, Compliance, market teams and PCO leadership to identify training needs for care integration team members.
Represent the organization in recruiting and marketing events as needed.
Maintain active clinical practice in the local market for a portion of the time. This is currently set to 10%.
Serves as a key SME interviewer in future RN hires to promote standardized and consistent hiring approach.
May serve as faculty for Activity Center topic of the month session or CIT Grand Rounds for CE credit as needed.
Travel up to 20% for onsite training delivery, role observation, and clinical practice
Use your skills to make an impact
Required Qualifications
Active and unrestricted RN License in home state
Willingness to obtain licensure in additional states as needed
Minimum of five years' experience working as a Registered Nurse
Knowledge of community health and social service agencies and resources
Experience working as part of an interprofessional team
Experience in training and/or training content development
Proficient in Microsoft Office, EMR systems, and Zoom
Preferred Qualifications
Familiarity with state Medicaid guidelines and application processes preferred.
Preferred experience working with the geriatric/senior population
Preferred experience in care management program management or implementation
Knowledge of EMR/documentation platforms including Salesforce and AthenaOne
Knowledge of Team STEPPS evidenced-based standards
Key Competencies
Clinical Workflow Expertise: You demonstrate up-to-date knowledge of relevant clinical workflows and protocols
Training Delivery and Presentation: You facilitate engaging and structured didactic training sessions, utilizing available technology to maximize training effectiveness
Content Development: You develop clear, relevant, and evidence-based training materials tailored to the role(s) you are supporting
Communication and Leadership: You communicate and advocate effectively and professionally with clinical leadership and interprofessional teams. You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience
Strategic Thinking & Systems Contribution: You provide meaningful input during program design discussions, including identifying opportunities for innovation and improvement. You are a problem solver with the ability to identify needs and drive the work with low to moderate oversight
Clinical Knowledge Application : You apply clinical knowledge appropriately within a value-based care model
Coaching & Staff Development: You support staff development through mentorship, role-modeling, reverse shadowing, and constructive strengths-based feedback
Additional Information
Remote role
Reside in an existing PCO market to support clinical practice within the market
Ability to travel up to 20%, largely within local and regional markets.
Flexibility with work location; locations listed in job posting are preferred
Work from Home Requirements
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Satellite, cellular and microwave connection can be used only if approved by leadership
Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
Reporting Structure
Reports to Associate Director of Clinical Education under the leadership of the National AVP, Clinical Education.
Collaborates closely with the Clinician Development Committee, Operational Learning Team, Clinical Education Team, and other training partners.
Benefits and Perks:
- At Humana, we value our employees and are committed to providing a supportive and rewarding wo
