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