Remote Nurse Navigator (LVN or RN)
Job Title: Nurse Navigator
Location: Remote
Type: Full-Time
About Us:
Trinity Care Navigation, part of the Trinity Captive Group, is redefining healthcare delivery by combining compassionate clinical support with innovative cost-management strategies. Our mission is to simplify the healthcare journey for members while helping employers achieve measurable savings through proactive, data-driven navigation.
The Nurse Navigator plays a critical role in guiding members with complex or high-cost medical needs through their healthcare journey—providing clinical expertise, coordination, and education to improve outcomes and reduce costs.
Key Responsibilities:
Clinical Guidance & Support
• Serve as a clinical resource for members navigating high-cost or complex healthcare conditions, including surgical, infusion therapy, oncology, and specialty medication cases.
• Provide education on diagnoses and treatment options,
• ensuring members understand their next steps and available support.
• Identify opportunities for care optimization such as site-of-care redirection, second opinions, and bundled services.
Care Coordination
• Collaborate with providers, TPAs, and other partners to coordinate timely, high-quality care for members.
• Schedule and track services, follow-up appointments, and transitions of care to ensure continuity.
• Partner with Patient Navigation Coordinators to ensure a seamless member experience from intake through resolution.
Cost Management & Steerage
• Review claims and utilization data to identify high-cost or emerging large-claim cases.
• Engage members proactively to discuss alternative care pathways, cost-effective providers, and programs that align with plan design.
• Track and document savings and clinical outcomes related to steerage and coordination efforts.
Documentation & Compliance
• Maintain accurate and timely documentation of all interactions in accordance with Trinity Care Navigation standards and HIPAA requirements.
• Ensure all clinical recommendations are evidence-based and compliant with plan guidelines and policies.
Qualifications:
• Active Registered Nurse (RN) or Licensed Vocational Nurse (LVN) license, in good standing, in State of Texas.
• Minimum 3–5 years of clinical experience in one or more of the following: case management, medical/surgical, or oncology.
• Strong understanding of healthcare systems, claims data, and cost-containment principles.
• Excellent communication and critical-thinking skills, with the ability to engage both clinically and compassionately.
• Experience working with self-funded employer groups, TPAs, or stop-loss carriers preferred.
• Bilingual (Spanish) is a plus.
Skills:
• Strong clinical judgment and critical thinking abilities.
• Excellent communication and interpersonal skills for interacting with patients, families, and healthcare providers.
• Proficient in using electronic health records (EHR) and case management software.
• Ability to work independently in a remote environment, managing multiple cases simultaneously.
Why Join Trinity Care Navigation?
Be part of a purpose-driven team transforming how healthcare is delivered and financed. We offer a collaborative, remote work environment, competitive compensation, and opportunities to make a measurable impact—helping members achieve better outcomes while supporting cost savings for our clients.
Apply Now
Apply Now
Location: Remote
Type: Full-Time
About Us:
Trinity Care Navigation, part of the Trinity Captive Group, is redefining healthcare delivery by combining compassionate clinical support with innovative cost-management strategies. Our mission is to simplify the healthcare journey for members while helping employers achieve measurable savings through proactive, data-driven navigation.
The Nurse Navigator plays a critical role in guiding members with complex or high-cost medical needs through their healthcare journey—providing clinical expertise, coordination, and education to improve outcomes and reduce costs.
Key Responsibilities:
Clinical Guidance & Support
• Serve as a clinical resource for members navigating high-cost or complex healthcare conditions, including surgical, infusion therapy, oncology, and specialty medication cases.
• Provide education on diagnoses and treatment options,
• ensuring members understand their next steps and available support.
• Identify opportunities for care optimization such as site-of-care redirection, second opinions, and bundled services.
Care Coordination
• Collaborate with providers, TPAs, and other partners to coordinate timely, high-quality care for members.
• Schedule and track services, follow-up appointments, and transitions of care to ensure continuity.
• Partner with Patient Navigation Coordinators to ensure a seamless member experience from intake through resolution.
Cost Management & Steerage
• Review claims and utilization data to identify high-cost or emerging large-claim cases.
• Engage members proactively to discuss alternative care pathways, cost-effective providers, and programs that align with plan design.
• Track and document savings and clinical outcomes related to steerage and coordination efforts.
Documentation & Compliance
• Maintain accurate and timely documentation of all interactions in accordance with Trinity Care Navigation standards and HIPAA requirements.
• Ensure all clinical recommendations are evidence-based and compliant with plan guidelines and policies.
Qualifications:
• Active Registered Nurse (RN) or Licensed Vocational Nurse (LVN) license, in good standing, in State of Texas.
• Minimum 3–5 years of clinical experience in one or more of the following: case management, medical/surgical, or oncology.
• Strong understanding of healthcare systems, claims data, and cost-containment principles.
• Excellent communication and critical-thinking skills, with the ability to engage both clinically and compassionately.
• Experience working with self-funded employer groups, TPAs, or stop-loss carriers preferred.
• Bilingual (Spanish) is a plus.
Skills:
• Strong clinical judgment and critical thinking abilities.
• Excellent communication and interpersonal skills for interacting with patients, families, and healthcare providers.
• Proficient in using electronic health records (EHR) and case management software.
• Ability to work independently in a remote environment, managing multiple cases simultaneously.
Why Join Trinity Care Navigation?
Be part of a purpose-driven team transforming how healthcare is delivered and financed. We offer a collaborative, remote work environment, competitive compensation, and opportunities to make a measurable impact—helping members achieve better outcomes while supporting cost savings for our clients.
Apply Now
Apply Now