Major Responsibilities:
Provides continuity of care by ensuring smooth transitions between care settings. Develops a relationship with patient and their multidisciplinary team to facilitate and/or navigate through subsequent treatment and follow-up to reflect continuity of care.
Completes a nursing assessment to identify the patient's individualized needs and collaborates with multidisciplinary team and other departments to develop an interdisciplinary plan of care.
Supports the patient and family by providing education, addressing psychosocial needs, advocating, providing continuity of care and identifying barriers to care. Navigates patients and family members throughout the diagnosis, treatment and follow-up of the patient throughout the continuum of care.
Provides expert clinical advice to the multidisciplinary team in designing collaborative teaching plans/programs and in planning/providing patient/family education and discharge planning including wellness and health maintenance within designated specialty.
Coordinates timely, seamless, evidenced based care across the care continuum resulting in best patient outcomes.
Evaluates, selects or designs patient education materials on specific disease site programs. Provides education and outreach programs to patients, Aurora staff and to members of the community.
Assist leadership in developing program vision, goals and objectives. Assists in the development, implementation and maintenance of quality programs that include best practice patient care outcomes including quality of life, and enhanced patient loyalty.
Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the department's policies and procedures. Age-specific information is developed further in the departmental job standards.

Licensure, Registration and/or Certification Required:
Registered Nurse license issued by the state in which the team member practices, and
Heart Failure (CHFN) Certification from Cardiovascular Nursing Education Associates (CNEA) needs to be obtained within 2 years, and
Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association (AHA) needs to be obtained within 6 months unless department leader has determined it is not required.


Education Required:
Bachelor's Degree in Nursing.

Experience Required:

Typically requires 5 years of experience in cardiology nursing that includes performing nursing assessments, care plan development and educating patients.

Knowledge, Skills & Abilities Required:
Working knowledge of the components of quality and acute patient care needs specifically related to heart failure.

Maintains clinical expertise to effectively manage physical, emotional, psychosocial and spiritual needs of patients throughout the care continuum.

Excellent analytical and interpersonal communication skills necessary to negotiate with families, patient, physicians and third party payers.

Demonstrated ability to work well with physicians and other professionals in a direct and positive manner.

Physical Requirements and Working Conditions:

Clear oral communications and hearing acuity required for receiving instructions and converse on standard telephone.

Functional speech and hearing to allow for effective communication of instructions and conversation over the telephone.

Exposed to normal office environment.

Operates all equipment necessary to perform the job.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.