Transitional Care Navigator

A clinically trained – experienced business development and sales professional that will focus on expanding the reach and impact of clinical hospice services, by identifying and securing new upstream referral-sources and education and awareness opportunities, building relationships, and driving the most appropriate and dignified hospice care for the patient – across physicians, providers and hospitals.

A successful candidate must be self-driven, hunter-sales mentality and drive, and have a strong sense of curiosity, resilience, adaptability, and the ability to find, develop, build and leverage referring-relationships. Experienced communicator, strategic thinking, and problem-solving, always looking for ways to expand and create value for the patient and organization.

This is not a virtual role – based in a market territory and assigned physicians, hospitals, assessing clinical information, finding and driving upstream hospice referrals and providing upstream and downstream education and awareness to Physicians, hospitals, and other providers.

• →A clinical-sales transitional care navigator/TCN - who will build upstream-referral relationships and transition hospice referrals from physicians and other referral sources.
• →Serve as hospice clinical consultant and educator, acting as extensions of hospital and physician care team.
• →Review hospital clinical documentation/EMR/HCHB, engage with patients and providers to build clinical patient profiles and clinical-admission-assessments and identify decline patterns (i.e. frequent hospitalizations, functional deterioration, etc.).
• →Consult with hospital care teams by sharing clinical profiles and educating on hospice appropriateness.
• →Identify attending and consulting providers associated with referred patients – to provide patient assessment, eligibility and discharge education and awareness
• →Collaborate with field sales representatives to schedule and conduct consultative meetings with external care teams.
• →Initiate and maintain care team workflows for:
  • →Patient information / clinical assessment and documentation
  • →Consultation / education planning and delivery
  • →External and internal meetings and preparations

• →Identify trends, needs, and partnership opportunities for earlier hospice engagement.
• →Foster effective and trusted relationships with external care teams to improve patient outcomes and enhance end-of-life satisfaction.
• →Communicate clearly and consistently with hospital leadership and care coordination teams.
• →Effectively organize, track and prioritize high-value patient comprehensive reviews.
• →Meet all productivity requirements, including:
  • →Timely review of medical records
  • →Hospital and provider consultation and education

• →Promote a collaborative and team-focused environment.
• →Uphold hospice policies, privacy practices, and ethical guidelines.
• →Professionally represent the organization in all hospitals, community, and partner interactions.
• →Collaborate cross-functionally with internal hospice departments and leadership teams.
• →Perform other duties as assigned.

• Bachelor’s degree in marketing, business administration, or other related fields is preferred. An acceptable combination of experience and/or training may be considered instead of formal education.
• Licensed as a registered nurse in the state of practice, preferred.
• Minimum of two years relevant experience.
• Must possess the ability to make independent decisions when circumstances warrant.
• Must possess the ability to deal tactfully with patients, family members, visitors, agency personnel, and public.
• Must be knowledgeable of quality assessment and assurance procedures.
• Valid driver’s license and proof of insurance is required.

#ACHOS