Registered Nurse Navigator Home Health Review-Health Admin - Relocation Required
Company: CHRISTUS Health
Location: Houston
Posted on: January 4, 2026
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Job Description:
Job Description This job requires relocation. Description
Summary: The RN Navigator Home Health Review monitors home health
patients to ensure patients continue to meet the CMS criteria for
services. They are a member of the patient’s care team and act as a
patient advocate, providing proactive outreach to CHRISTUS Health
value-based payer patients. The RN Navigator makes recommendations
to primary care providers regarding ongoing services. The RN
Navigator facilitates communication and coordinates care with
physicians, the providers’ clinic, hospital facilities, family,
caregivers, and other community healthcare providers. The Associate
will support transitions of care as needed. Responsibilities: -
Meets expectations of the applicable OneCHRISTUS Competencies:
Leader of Self, Leader of Others, or Leader of Leaders. - Stays
abreast of current CMS and other payer guidelines for Home Health
services. - Receives and evaluates Home Health 485 form (Plan of
Care) based on Medical Necessity guidelines and Homebound Status
requirements. - Facilitates Case Conferences with Home Health
Agencies for evaluation of patient progress toward goals and
discharge plan. - Ensures Home Health agency is addressing the
problem list and providing appropriate follow up for patient needs.
- Based on CMS or other payer guidelines, patient assessment, and
case conferences, makes recommendation to PCP regarding Home Health
recertification or discharge from service. - Utilizes MCG
Guidelines for Home Care to optimize the type, frequency, and
duration of care. - Creates positive relationships with Home Health
agencies as well as Primary Care Clinicians and Office Staff. -
Ensures smooth transition of care along the continuum. -
Facilitates communication between Home Health agencies and PCP
practices as necessary to ensure patient's needs are addressed. -
Demonstrates expertise in navigating electronic medical record and
other care management applications. - Monitors key measures of
program success and provides feedback regarding opportunities to
improve. - Collaborates with team members in the discharge process,
performing outreach/documentation according to CMS guidelines and
the Population Health workflow. - Outreach to TOC patients should
focus on medication reconciliation/adherence, self-management, use
of personal health records, follow-up with PCPs/Specialists, and
review of indicators that a patient’s condition is worsening and
how to respond. - Promotes a positive work environment by
displaying a caring, sensitive approach to others, as evidenced by
listening, understanding, and responding to the needs of patients,
colleagues, and supervisors. - Performs other duties as assigned.
Job Requirements: Education/Skills - Bachelor’s Degree in Nursing
preferred. Experience - 3-5 years of clinical experience required.
- 2 years of Home health experience preferred. - 2-3 years of
managed care and/or care management experience preferred. Licenses,
Registrations, or Certifications - RN license in the state of
employment or compact is required. Work Schedule: 5 Days - 8 Hours
Work Type: Full Time
Keywords: CHRISTUS Health, Houston , Registered Nurse Navigator Home Health Review-Health Admin - Relocation Required, Healthcare , Houston, Texas
