transitions rn care coordinator

Amedisys

<div>Overview:
<div><b>Make a difference every day as an Amedisys care transitions coordinator</b></div><div>
Join Amedisys-one of the largest and most trusted home health and hospice companies in the U.S.-where flexibility, purpose and growth come together to help patients heal where they feel most comfortable, at home.This role requires an RN, LPN or other clinical license, plus previous outside sales/business development experience in the healthcare industry. A background in cold calling customers in pharmaceuticals, medical device sales, hospital, home health, hospice or long-term care is ideal.</div><div>
</div><div><b>
Attractive pay</b></div><p></p><p><br>
$70,000-$75,000</p><div><br>
</div><div><b>
Territory</b></div><div>
</div><div><b>
Bristol TN</b></div><div><b>
What's in it for you</b></div><div><ul><li>
Choice of PPO or HSA medical plans with free telehealth.</li><li>
Paid time off.</li><li>
Up to $1,000 in free healthcare services with Amedisys HSA plan.</li><li>
Up to $500 in wellness rewards for activities-use for spa, gym, sports, hobbies, pets and more.*</li><li>
Mental health support with up to five free counseling sessions through the Employee Assistance program.</li><li>
401(k) with a company match.</li><li>
Family support with infertility treatment coverage*, adoption reimbursement, paid parental and family caregiver leave.</li><li>
Fleet vehicle program (restrictions apply) and mileage reimbursement.</li><li>
And more.</li></ul><ul><li><i>Benefit eligibility can vary by position and shift status.</i></li><li><i>Participation requires enrollment in an Amedisys medical plan.</i></li></ul></div>
Responsibilities:
<ul><li>Educates health care professionals, patients, and families about home care services.</li><li>
Develops and maintains relationships with key referral sources, such as hospitals, nursing homes and physician offices to generate leads.</li><li>
Coordinates patient admissions with the team, including obtaining all required documentation to complete referral to admission process.</li><li>
Conducts on-site visits to assess patient needs and identify barriers to care.</li><li>
Keeps accurate records of patient interactions and referrals.</li><li>
Achieves admissions, product, and payor-mix goals.</li><li>
Meets short and long-term target account goals.</li><li>
Documents the minimum expectation of sales calls daily in CRM (including pre and post call notes).</li><li>
Maintains a complete, up-to-date record of targeted referral sources in territory in CRM.</li><li>
Attends community events to promote Amedisys.</li><li>
Responds to customer complaints in timely manner.</li><li>
Performs other duties as assigned.</li></ul>
Qualifications:
<ul><li>At least one year of experience in a healthcare related business development/outreach role. A bachelors degree is preferred, but not required.</li><li>
Current RN or LPN license, specific to the state(s) you are assigned to work. MSW, LCSW, PT, PTA, OT, OTA, SLP, and PA licenses are considered in some cases.</li><li>
Reliable transportation, current driver's license, and liability insurance.</li></ul><div><b>
Please note</b>: This role will travel 50% or more within the assigned territory.</div><div></div><div><i>
Our compensation reflects the cost of labor across several U.S. geographic markets and may vary depending on location, job-related knowledge, skills, and experience.</i></div><p><i>
Amedisys is an equal opportunity employer. All qualified employees and applicants will receive consideration for employment without regard to race, color, religion, sex, age, pregnancy, marital status, national origin, citizenship status, disability, military status, sexual orientation, genetic predisposition or carrier status or any other legally protected characteristic.</i></p></div>

Care Transitions Coordinator RN/LPN Clinical Sales

<div>Overview:
<div>Are you looking for a rewarding career as a care transitions coordinator? If so, we invite you to join our team at Amedisys, one of the largest and most trusted home health and hospice companies in the U.S. This role requires an RN, LPN or other clinical license, plus previous outside sales/business development experience in the healthcare industry. A background in cold calling customers in pharmaceuticals, medical device sales, hospital, home health, hospice or long-term care is ideal.</div><div>
</div><div><b>
Attractive pay</b></div><div></div><div><br>
$85,000-$95,000</div><div><br>
</div><div><b>
Territory</b></div><div></div><div><br>
Baltimore County / Baltimore City</div><div><br>
</div><div><b>
What's in it for you</b></div><ul><li>
A full benefits package with choice of affordable PPO or HSA medical plans.</li><li>
Paid time off.</li><li>
Up to $1,000 in free healthcare services paid by Amedisys yearly, when enrolled in an Amedisys HSA medical plan.</li><li>
Up to $500 in wellness rewards for completing activities during the year. Use these rewards to support your wellbeing with spa services, gym memberships, sports, hobbies, pets and more.*</li><li>
Mental health support, including up to five free counseling sessions per year through the Amedisys Employee Assistance program.</li><li>
401(k) with a company match.</li><li>
Family support with infertility treatment coverage*, adoption reimbursement, paid parental and family caregiver leave.</li><li>
Fleet vehicle program (restrictions apply) and mileage reimbursement.</li><li>
And more.</li></ul><div>
Please note: Benefit eligibility can vary by position depending on shift status.</div><ul><li>To participate, you must be enrolled in an Amedisys medical plan.</li></ul>
Responsibilities:
<ul><li>Educates health care professionals, patients, and families about home care services.</li><li>
Develops and maintains relationships with key referral sources, such as hospitals, nursing homes and physician offices to generate leads.</li><li>
Coordinates patient admissions with the team, including obtaining all required documentation to complete referral to admission process.</li><li>
Conducts on-site visits to assess patient needs and identify barriers to care.</li><li>
Keeps accurate records of patient interactions and referrals.</li><li>
Achieves admissions, product, and payor-mix goals.</li><li>
Meets short and long-term target account goals.</li><li>
Documents the minimum expectation of sales calls daily in CRM (including pre and post call notes).</li><li>
Maintains a complete, up-to-date record of targeted referral sources in territory in CRM.</li><li>
Attends community events to promote Amedisys.</li><li>
Responds to customer complaints in timely manner.</li><li>
Performs other duties as assigned.</li></ul>
Qualifications:
<ul><li>At least one year of experience in a healthcare related business development/outreach role. A bachelors degree is preferred, but not required.</li><li>
Current RN or LPN license, specific to the state(s) you are assigned to work. MSW, LCSW, PT, PTA, OT, OTA, SLP, and PA licenses are considered in some cases.</li><li>
Reliable transportation, current driver's license, and liability insurance.</li></ul><div>
</div><div>
Please note: This role will travel 50% or more within the assigned territory.</div><div>
</div><div><i>
Our compensation reflects the cost of labor across several U.S. geographic markets and may vary depending on location, job-related knowledge, skills, and experience.?</i></div><div></div><div><i><br>
Amedisys is an equal opportunity employer. All qualified employees and applicants will receive consideration for employment without regard to race, color, religion, sex, age, pregnancy, marital status, national origin, citizenship status, disability, military status, sexual orientation, genetic predisposition or carrier status or any other legally protected characteristic.</i></div></div>

Ascension at Home

<div>
 <strong>
  Company
  <br/>
  <br/>
 </strong>
 Ascension at Home together with Compassus
 <br/>
 <br/>
 <strong>
  Position Summary
  <br/>
  <br/>
 </strong>
 <strong>
  This is a float RN role. Role will float to Ascension hospitals but support primarily Seaton Main. Registered Nurse required.
  <br/>
  <br/>
 </strong>
 The Home Health Care Transition Coordinator is responsible for modeling the Compassus values of Compassion, Integrity, Excellence, Teamwork, and Innovation and for promoting the Compassus philosophy, using the 6 Pillars of Success as the foundation. S/he is responsible for upholding the Code of Ethical Conduct and for promoting positive working relationships within the company, among all departments, and all external stakeholders. The Home Health Care Transition Coordinator serves as a trusted resource for the physician and hospital case managers and communicates with referral sources. S/he conducts skilled conversations with physicians, patients, families, and healthcare providers. S/he maintains an understanding of hospital and post-acute healthcare systems. The Home Health Care Transition Coordinator navigates getting patients into the right care at the right time.
 <br/>
 <br/>
 <strong>
  Position Specific Responsibilities
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Meets regularly with physicians in the hospital to discuss specific patients: gives guidance and provides an understanding of post-acute service support; ensures continuity of care as a priority.
  </li>
  <li>
   Acts as hospital case managers (rounding or interactions in step with the hospital): high-risk patient reviews.
  </li>
  <li>
   Supports transition to home health, home infusion, and hospice services by conducting in-person bedside transitions; where services are offered.
  </li>
  <li>
   Educates on hospice, home infusion, and home health benefits to patient families and referral sources.
  </li>
  <li>
   Develops genuine collegial relationships with other Ascension professionals and identifies times to meet regularly with clinicians to problem solve and review cases.
  </li>
  <li>
   Understands how to interact with difficult patients/families.
  </li>
  <li>
   Identifies steps to having a successful family meeting.
  </li>
  <li>
   Develops communication skills to support patients/families with difficult discussions or differing points of view.
  </li>
  <li>
   Maintains a current list of admission coordinators for each healthcare service line.
  </li>
  <li>
   Aligns recommendations between patient/family and Primary care team:
  </li>
  <ul>
   <li>
    Identifies patient preferences/needs.
   </li>
   <li>
    Identifies patient&rsquo;s post-acute care needs.
   </li>
   <li>
    Confirms the level of care most appropriate for the patient - right care, right time.
   </li>
   <li>
    Educates patient on Homebound criteria and verifies patient meets this requirement.
   </li>
   <li>
    Facilitates 'transition to home' planning including assessing post-discharge needs and developing and implementing a transition to the home plan.
   </li>
  </ul>
  <li>
   Sets patient-centered goals and facilitates transitions:
  </li>
  <ul>
   <li>
    Understands how to identify patient/family-specific treatment goals.
   </li>
  </ul>
  <li>
   Arranges for home admission &ndash; communication with the Home Health and Home Infusion team(s).
  </li>
  <li>
   Coordinates patient care by obtaining H&amp;P, physician orders, hospital records, and face-to-face documentation promptly.
  </li>
  <li>
   Verifies patient demographic information is correct.
  </li>
  <li>
   Coordinates organization of transfer orders; educates patients on home care orders and home care services.
  </li>
  <li>
   Identifies primary care physician to follow the plan of care.
  </li>
  <li>
   Conducts follow-up on re-hospitalized home health patients.
  </li>
  <li>
   Participates in home health re-hospitalization mitigation strategies &ndash; be a member of the strategy team.
  </li>
  <li>
   Develops ability to understand and digest claims data, and use of predictive analytics.
  </li>
  <li>
   Ensures excellent customer service to maintain and grow the business in the identified key accounts.
  </li>
  <li>
   Consistently works to improve personal knowledge and sales skills to become of greater value to our most important customers and the company.
  </li>
  <li>
   Meets or exceeds assigned quotas, thereby maintaining and constantly improving the HH's competitive position.
  </li>
  <li>
   Performs other duties as assigned.
   <br/>
  </li>
 </ul>
 <strong>
  Education And/or Experience
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Bachelor&rsquo;s degree preferred.
  </li>
  <li>
   Two (2) to three (3) years of nursing experience as an RN required.
  </li>
  <li>
   Hospital and/or long-term care clinical experience highly preferred.
  </li>
  <li>
   Experience with home health eligibility admission requirements, COPs, PDGM knowledge and training, risk scoring/data analysis, introduction to end-of-life practices/spiritual history, homebound status determination, palliative care, General Dx and LCDs, and estimating and communicating prognosis/disease trajectory preferred.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Skills
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percentage.
  </li>
  <li>
   Language Skills: Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from leaders, team members, investors, and external parties. Strong written and verbal communications.
  </li>
  <li>
   Other Skills and Abilities: Ability to understand, read, write, and speak English. Articulates and embraces hospice philosophy.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Certifications, Licenses, and Registrations
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Active and unencumbered Registered Nurse license in the state(s) of employment required.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Physical Demands and Work Environment:
 </strong>
 The demands of this role necessitate a team member to effectively perform essential functions. Adaptations can be made to accommodate team members with disabilities. Regular standing, walking, and manual dexterity are fundamental, along with the ability to lift and move objects up to 50 pounds. Visual acuity requirements include close and distance vision, color and peripheral vision, depth perception, and the ability to adjust focus. In a healthcare setting, exposure to bodily fluids, infectious diseases, and conditions typical to the field is expected. Routine use of standard medical equipment and tools associated with clinical care is essential. This description provides a general overview and may vary by role and department, capturing the nuanced demands and conditions inherent to clinical positions in our organization.
 <br/>
 <br/>
 At Compassus, including all Compassus affiliates, diversity, equity, and inclusion are fundamental to our Pillars of Success. We are committed to creating a fair work environment where our team members feel welcomed, highly valued, and respected. As an equal opportunity employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
 <br/>
 <br/>
 <strong>
  Build a Rewarding Career with Compassus
  <br/>
  <br/>
 </strong>
 At Compassus, we care for our team members as much as we care for our patients and their families. Through our Care for Who I Am culture, we show compassion, respect, and appreciation for every individual. Embark on a career that cares for you while you care for others.
 <br/>
 <br/>
 <strong>
  Your Career Journey Matters
  <br/>
  <br/>
 </strong>
 We&rsquo;re dedicated to helping you grow and succeed. Whether you&rsquo;re pursuing leadership roles, specialized training, or exploring new career paths, we provide the tools and support you need to thrive.
 <br/>
 <br/>
 <strong>
  The Compassus Advantage
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Meaningful Work: Make an impact every day by honoring the quality of life of our patients, supporting them and their families with compassion, and creating moments that truly matter.
  </li>
  <li>
   Career Development: Access leadership pathways, mentorship, and personalized professional development.
  </li>
  <li>
   Innovation Meets Compassion: Collaborate with a supportive team using the latest tools and technologies to deliver exceptional care.
  </li>
  <li>
   Enhanced Benefits: Enjoy competitive pay, flexible time off, tuition reimbursement, and wellness programs designed for your well-being.
  </li>
  <li>
   Recognition and Support: Be celebrated for your contributions through recognition programs that honor your dedication.
  </li>
  <li>
   A Culture of Belonging: Thrive in a culture where you can be your authentic self, valued for your unique contributions and supported in a community that embraces diversity and inclusion.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Ready to Join?
  <br/>
  <br/>
 </strong>
 At Compassus, your career is more than a job&mdash;it&rsquo;s an opportunity to make a lasting impact. Take the next step and join a team that empowers you to grow, innovate, and thrive.
 <br/>
 <br/>
</div>


Home Health Care Transition Coordinator - RN Required

Soleo Health

<div>Description:
<p>
Soleo Health is seeking a <b>Clinical Transition Coordinator</b> to support our patients in the <b>Macon, GA </b>and surrounding areas.<b> </b>Join us in Simplifying Complex Care! <b>RN license required</b></p><p><b>
Soleo Health Perks:</b></p><ul><li>
Competitive Wages</li><li>
401(k) with a Match</li><li>
Referral Bonus</li><li>
Paid Time Off</li><li>
Great Company Culture</li><li>
Paid Parental Leave Options</li><li>
Affordable Medical, Dental, and Vision Insurance Plans</li><li>
Company Paid Disability and Basic Life Insurance</li><li>
HSA and FSA (including dependent care) Options</li><li>
Education Assistance Program</li></ul><p><b>
The Position:</b></p><p>
The Clinical Transition Coordinator will primarily work closely with physicians in various specialty areas, case managers, internal sales, clinical and operations team members to coordinate a patient&rsquo;s care transition from hospital or healthcare facility to an alternative site of care. In addition to providing a significant level of patient and family education related to their illness and planned treatment, this function will be responsible to secure new referral sources in collaboration with the local territory manager and local operations manager. The position will assist patients in their transfer to alternative sites of care only after the patient&rsquo;s physician has ordered homecare services and the patient has selected the company as their provider of choice.</p><p><b>
Responsibilities include:</b></p><ul><li><b>
Sales Support/Patient Referral: </b>Work with the Regional Vice President and sales team to strategize and secure new referral sources in a geographic market. Work collaboratively with the local territory manager to gain new referrals from physicians, case managers, and other potential points of call. Promotes the company internally and externally while assisting in the development of strategic planning initiatives.</li><li><b>
Patient Coordination: </b>Works closely with multidisciplinary team to maintain and implement up-to-date coordinated care plan to transition to an alternative site; communicates with all members of the healthcare team on behalf of the patient. Provide feedback to healthcare providers regarding the acceptance and progress of patients and document all demographic, clinical, and payer information. Assists branch staff in securing necessary paperwork and signatures needed to commence therapy and submit for payer reimbursement, as necessary.</li><li><b>
Nurse Liaison: </b>Communicates with referring physician&rsquo;s office as appropriate to the patient and physician&rsquo;s needs. Works with hospital case management as a liaison between the company and healthcare providers, including discussing the benefits of specialty infusion services and clinical outcomes.</li><li><b>
Patient/Family Education:</b> Conducts pre-discharge hospital patient visits at the healthcare provider&rsquo;s request to determine the need and eligibility for specialty infusion services; introduces the company upon acceptance of a healthcare provider&rsquo;s referral and explains available services and financial/payer responsibilities to patient prior to discharge. Works with marketing and sales team to educate physicians and facilities on available specialty infusion services. Serves as a patient advocate and conduit to the company.</li><li><b>
Administrative: </b>Maintains accurate, and submits on a timely basis: expense reports, referral tracking, mileage reports, territory reports, sales plans and other documents and training programs mandated by the company, as appropriate.</li></ul><p><b>
Schedule:</b></p><ul><li>
Standard business hours, Monday-Friday 8:30am -5pm, 40 hours per week</li><li>
On-call rotation- 1x every 9 weeks (taking phone calls over the weekend)</li><li>
Must have properly registered insured vehicle to drive 100+ miles as needed</li></ul>
Requirements:
<ul><li>Bachelor's degree or medical background preferred.</li><li>
Registered Nurse required</li><li>
Minimum five (5) years of clinical experience, home health field or management experience preferred.</li><li>
Knowledge of hospitals, skilled nursing/rehab facilities including case management and discharge planning service needs.</li><li>
Advanced practice expertise to identify and implement improvement processes, and the ability to design, direct and implement health care plans on behalf of the patient.</li></ul><p><b>
About Us: </b>Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference!</p><p><b>
Soleo&rsquo;s Core Values:</b></p><ul><li>
Improve patients&rsquo; lives every day</li><li>
Be passionate in everything you do</li><li>
Encourage unlimited ideas and creative thinking</li><li>
Make decisions as if you own the company</li><li>
Do the right thing</li><li>
Have fun!</li></ul><p>
Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.</p><p>
Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.</p><p>
Keywords: Now Hiring, Hiring Now, Hiring Immediately, Immediately Hiring,</p><p>
#INDALL</p></div>

Clinical Transition Coordinator - RN

Prominence Health Plan

<div>Responsibilities:
<p>
Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.</p><p></p><p><br>
Learn more at: https://prominence-health.com/</p><div></div><div><b><br>
Job Summary: </b>The Transitional Care (TOC) Nurse is responsible for managing a member&rsquo;s successful transition from an acute or post-acute level of care to home and is accountable for developing, implementing, and evaluating comprehensive transitional care interventions for high risk medical and/or surgical members for Prominence Health Plan. He/she is responsible for facilitating the post-acute care of members that are at risk for poor health outcomes, frequent emergency room visits, and hospital readmissions.</div><div>
The TOC nurse identifies hospitalized high-risk, complex members for program enrollment and communicates with all entities involved in the care of the member to promote and maximize care coordination. Key aspects of the TOC Program protocols are based upon inpatient and post-discharge workflows. Inpatient/SNF workflow includes visiting members at the bedside, member and family education regarding disease states and self-care, identification of member-level concerns regarding discharge, and anticipation of potential gaps in care. The inpatient/SNF encounters are designed to educate members/caregivers surrounding their post discharge health care needs and to empower them to play an active and informed role in managing their care post-discharge.</div><div>
Upon member hospital/SNF discharge, the post-discharge workflow includes a home visit, when appropriate and scheduled periodic telephonic follow-up for 30 days. This includes a focus on medication reconciliation and adherence, management of member&rsquo;s quality of life and functionality, management of both acute and chronic disease states, identification and rectifying gaps in care, support of member&rsquo;s ability to perform self-cares, coordination of post-discharge appointments and services (durable medical equipment, home health), and coordination of care across the care continuum.</div><div></div><p><b><br>
Benefit Highlights:</b></p><ul><li>
Loan Forgiveness Program</li><li>
Challenging and rewarding work environment</li><li>
Competitive Compensation &amp; Generous Paid Time Off</li><li>
Excellent Medical, Dental, Vision and Prescription Drug Plans</li><li>
401(K) with company match and discounted stock plan</li><li>
SoFi Student Loan Refinancing Program</li><li>
Career development opportunities within UHS and its 300+ Subsidiaries! &middot; More information is available on our Benefits Guest Website: benefits.uhsguest.com</li></ul><p></p><p><b><br>
About Universal Health Services:</b></p><p>
One of the nation&rsquo;s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World&rsquo;s Most Admired Companies by Fortune; and listed in Forbes ranking of America&rsquo;s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
</p>Qualifications:
<div><b>
Qualifications and Requirements:</b></div><ul><li>
Registered Nurse with a BSN or MSN degree preferred; OR</li><li>
Bachelor&rsquo;s or master&rsquo;s degree in Public Health or related Field</li><li>
Active, unrestricted, current, and valid Registered Nurse licenses in the States of Practice (Nevada, Texas and/or Florida), required</li><li>
Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ), preferred.</li><li>
Minimum of three (3) years of Case Management/Transition of Care experience in a managed care environment required.</li><li>
Recent (within past 3 years) working knowledge of Milliman Care Guidelines, preferred.
</li><li>Minimum of three years (3) in clinical medical/surgical nursing practice within a hospital or Skilled Nursing Facility setting, preferred.
</li><li>Ability to effectively communicate in English (Nevada, Texas, and Florida markets), Spanish (Texas and Florida markets) and/or Tagalong (Florida market), both verbally and in writing depending on the State of RN licensure and employment location.</li><li>
Proficiency in gathering and interpreting empirical evidence, formulating recommendations, action plans and interventions to improve the overall organization strategy.</li><li>
Simultaneous action at varying stages&mdash;initiation, follow through, and completion&mdash;on a number of different projects.</li><li>
Demonstrated ability to research, analyze and interpret state/federal regulations related to health insurance and healthcare.</li><li>
Demonstrated ability to communicate verbally and with technical writing in a way that effectively conveys project background, objectives, activities, evaluations, conclusions, and recommendations.</li><li>
Demonstrated skills in critical thinking, problem solving, and the analysis, interpretation, and evaluation of complex information.</li><li>
Demonstrated ability to work independently with minimal supervision.</li><li>
Demonstrated ability to maintain effective collaborative working relationships with staff.</li><li>
Resourceful, detail-oriented, and able to assimilate and analyze a wide variety of information, often working under deadline pressure with a variety of levels of staff.
</li><li>Strong project management skills.</li><li>
Computer Skills: Smartsheet, SharePoint, Microsoft Office (Word, Excel, PowerPoint), and database software.</li><li>
Experience working with the Medicare and Medicaid population segment preferred.</li><li>
Knowledge of Medicare/ Medicaid processes and compliance standards</li></ul><div></div><p><b><br>
EEO Statement</b></p><p>
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.</p><p></p><p><br>
We believe that diversity and inclusion among our teammates is critical to our success.</p><p></p><p><br>
Avoid and Report Recruitment Scams</p><p></p><p><br>
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS</p><p>
and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.</p><p></p><p><br>
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.</p><p></p><p><br>
If you would like to learn more about the opportunity, please contact Bridget Gomez at: bridget.gomez@uhsinc.com</p></div>

RN - Transition of Care Nurse

Transitions Healthcare Allens Cove

<div>
 <strong>
  Registered Nurse (RN)
  <br/>
  <br/>
 </strong>
 <strong>
  SHIFT
  <br/>
  <br/>
 </strong>
 <strong>
  Monday to Friday 2pm - 10:00pm
  <br/>
  <br/>
 </strong>
 <strong>
  We are currently offering a $3,000 sign on bonus to anyone hired before the end of March, 2026.
  <br/>
  <br/>
 </strong>
 Transitions Healthcare Allens Cove is currently seeking a Registered Nurse (RN) to join 0ur team of talented caregivers.
 <br/>
 <br/>
 Transitions Healthcare Allens Cove&rsquo;s goal is to provide our employees with the resources, incentives, and flexibility they need to enjoy success in their role. Our communities provide challenging and gratifying work, recognize achievement, and promote career growth - in a professional and motivated environment.
 <br/>
 <br/>
 We offer competitive wages with an option to be paid on-demand, a suite of comprehensive benefits, and the opportunity to work for a healthcare team that shares a commitment to improving the health and well-being of all people in the communities we serve.
 <br/>
 <br/>
 Registered Nurse (RN) Responsibility Highlights include:
 <br/>
 <br/>
 <ul>
  <li>
   Assists in care planning for residents with need for advanced preparation of resident care.
  </li>
  <li>
   Timely completion of all paperwork requested by the Nursing Office (monitors, pharmacy reviews, etc.).
  </li>
  <li>
   Interacts with various disciplines in the facility to ensure maintenance of proper resident care and to exchange information regarding resident therapy and progress.
  </li>
  <li>
   Communicates changes in condition to MDS Coordinator, supervisor, restorative coordinator, and other necessary parties.
  </li>
  <li>
   Writes summaries of reasons why residents are being attended to, notes problems, and progress to assist physician in obtaining the proper care for the resident from consulting outside physicians.
  </li>
  <li>
   Performs initial assessment of new admissions and returnees from hospital, prepares documents for doctors&rsquo; orders, and orders medications as necessary.
  </li>
  <li>
   Make rounds to observe first-hand the conditions of the residents.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Registered Nurse (RN) Qualifications
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Registered Nurse in good standing with the Commonwealth of Pennsylvania.
  </li>
  <li>
   Two (2) years' experience in institutional resident care preferred.
  </li>
  <li>
   CPR and AED certification
   <br/>
   <br/>
  </li>
 </ul>
 eoe
 <br/>
 <br/>
 #THCAC
</div>


RN (Registered Nurse) Monday to Friday Evening Shift $ 3,000 Sign On Bonus!

Kaiser Permanente

<div><div><b>Job Summary:</b></div><br>
<br>
<p>Responsible for coordinating care for identified members with complex medical conditions in collaboration with hospital physicians, QRM staff (IPCC, CM, SW, PTSP), practitioners, medical office staff and other providers. The goal is to support and facilitate a smooth transition from the acute care setting or skilled nursing facility to alternative levels of care or home. Collaborates with physicians, telephonic care coordinators, inpatient case management/ social workers, telephonic to create a safe discharge plan for identified complex patients. Key job functions include assessment of identified members, development of a safe discharge plan from acute inpatient, skilled nursing, LTAC and Inpatient Rehab facilities. Coordinates post-acute services and follow- up medical care to ensure continuity of care. The Acute Transitional Case Manager (TCM) will identify and communicate any barriers to discharge plan. Ensures appoints and coordination of post-acute services with vendors.</p><div><b><br>
Essential Responsibilities:</b></div><br>
<br>
<ul><li>Responsible for all transitional case management activities outlined above.</li><li>
Conducts timely reviews and refers Transitional Case Management Program or Complex Case Management within designated timeframe per policy and procedure and evaluates priority for continuity of care case management based on established guidelines.</li><li>
Performs a thorough and objective telephonic assessment of the member including physical, psychosocial, environmental, financial, and health status expectation through the use of hospital records, contact with the member/family or significant others.</li><li>
Develops an individual, mutually established plan of care based on the assessment and utilizing motivational techniques, in conjunction with the KP Hospitalists and other practitioners that identifies specific interventions, objectives and goals with anticipated targeted dates for accomplishment.</li><li>
Attends patient care conferences (rounds) as scheduled with QRM physicians, and Telephonic IPCC work together to discuss clinical course, discharge planning and provide feedback on planned interventions, or barriers to care for member self-management to avoid delays and promote smooth transition.</li><li>
Proactively, implements the plan of care and specific interventions that will lead to the accomplishment of goals as defined. This may entail implementation prior to member discharge.</li><li>
Coordinates the resources necessary to accomplish the goals,and makes recommendations for modifications to the plan of care as necessary.</li><li>
Performs telephonic outreach to identified members within 48 hours post hospital discharge and completes assessment of member status.</li><li>
Coordinates and communicates plan of care to the Primary and/or Specialist Care providers, including follow-up appointment.</li><li>
Makes referral to other KP programs for continued care support.</li><li>
Documents all case management interactions and interventions according to departmental guidelines.</li><li>
Coordinates and participates in complex case management conferences on a regular basis for members involved in the care and updates the plan of care as necessary.</li><li>
Continuously coordinates, monitors, tracks and evaluates all care and services rendered to ensure that quality care is being delivered and in the most appropriate setting.</li><li>
Re-assess and reinforce members self-management skills, including symptom and medication management.</li><li>
Acts as a resource to facility Case Managers and discharge planners.</li><li>
Provides case management updates to practitioners and health care teams.</li><li>
Collaborates with the healthcare team to provide referral information and regarding community resource referrals.</li><li>
Arranges, coordinates and facilitates appointments for the member as necessary.</li><li>
Builds effective working relationships with practitioners and other departments within the health plan.</li><li>
Works in conjunction with disease specific population based care department as appropriate.</li><li>
Consults with Chief of QRM for potential non-approvals, benefit exceptions and other issues as appropriate.</li><li>
Assists in the development of guidelines and protocols.</li><li>
Investigates, identifies and reports problems and inefficiencies in existing systems, and recommends changes when appropriate to the Supervisor.</li><li>
Under the guidance of the Supervisor and in consultation with other QRM staff, participates in the coordination, planning, development, implementation, and maintenance of all QRM policies and procedures.</li><li>
Monitors utilization trends concerning inpatient and outpatient care in the market area, keeping appropriate management informed.</li><li>
Refers cases identified as risk management, peer review or quality issues to Quality and Risk Management.</li><li>
Provides documentation regarding any pertinent patient information or arrangements for inclusion in the members medical record.</li><li>
Works cross-functionally with other departments in striving to meet organizational goals and objectives.</li><li>
Participates in call rotation to support after hours and weekend referrals for quality resource management services.</li><li>
Acts as a team coach for respective areas of responsibility regarding enhanced customer service, quality of work performed and productivity of staff.</li><li>
Knowledgeable and compliant with regional personnel policies and procedures.</li><li>
Knowledgeable and compliant with QRM departmental and unit specific policies and procedures.</li><li>
Participates in annual regional and departmental compliance training.</li><li>
Knowledgeable and compliant with Principles of Responsibility.</li><li>
Develops and maintains an awareness of how to report compliance issues and concerns. Consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanentes policies and procedures.</li><li>
Your access to protected health information (PHI) will be limited to the minimum necessary required to effectively perform your job.</li><li>
May perform other duties as assigned.</li><li>
Other duties as assigned.</li></ul><div><br>
<b>Basic Qualifications:</b></div>
<div>Experience</div><br>
<br>
<ul><li>Minimum three (3) years acute hospital discharge planning or prior experience in case management as an RN.</li></ul><div>
Education</div><br>
<br>
<ul><li>High School Diploma or General Education Development (GED) required.</li></ul><div>
License, Certification, Registration</div>
Registered Professional Nurse License (Georgia) OR Licensed Clinical Social Worker (Georgia) OR Licensed Master Social Worker (Georgia)<br>
<ul><li>
</li></ul><br>
<div><b>Additional Requirements:</b></div><ul><li>
Complex Case Management experience.</li><li>
Experience acute patient populations including Medicare members.</li><li>
Functional knowledge of computers.</li><li>
Must be able to travel within the Atlanta metro area</li></ul><div>
<b>Preferred Qualifications:</b></div><br>
<br>
<ul><li>Bachelors Degree in Nursing or four (4) years of experience in a directly related field.</li></ul><br>
PrimaryLocation : Georgia,Atlanta,Regional Office - 9 Piedmont<br>
HoursPerWeek : 40<br>
Shift : Day<br>
Workdays : Mon, Tue, Wed, Thu, Fri<br>
WorkingHoursStart : 08:30 AM<br>
WorkingHoursEnd : 05:00 PM<br>
Job Schedule : Full-time<br>
Job Type : Standard<br>
Employee Status : Regular<br>
Employee Group/Union Affiliation : GUP|UFCW|Local 1996<br>
Job Level : Entry Level<br>
Job Category : QA, UR &amp; Case Management<br>
Department : Regional Office - 9 Piedmont - Rgnl Clinical Innovation - 2808<br>
Travel : No<br>
Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.</div>

RN QRM Acute Transitional Case Manager

Search 10000+ Transitions rn care coordinator jobs near you this March. New roles added regularly across leading industries. Apply today.

10000 transitions rn care coordinator jobs Near Me

Care Transitions Coordinator RN/LPN Clinical Sales

Care Transitions Coordinator RN/LPN Clinical Sales

Home Health Care Transition Coordinator - RN Required

Clinical Transition Coordinator - RN

RN - Transition of Care Nurse

RN (Registered Nurse) Monday to Friday Evening Shift $ 3,000 Sign On Bonus!

RN QRM Acute Transitional Case Manager