transitions rn care coordinator

Amedisys

<div>Overview:
<div>Make a difference every day as an Amedisys care transitions coordinator</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>
Attractive pay</div> 
$90,000-$100,000<div> 
</div><div>
Territory</div> 
Baltimore<div> 
</div><div>
What's in it for you</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>Benefit eligibility can vary by position and shift status.</li><li>Participation requires enrollment in an Amedisys medical plan.</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>
Please note: This role will travel 50% or more within the assigned territory.</div><div></div><div>
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.</div>
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.</div>

Care Transitions Coordinator RN/LPN Clinical Sales

Soleo Health

<div>Description:

Soleo Health is seeking a Clinical Transition Coordinator to support our Mobile, AL specialty infusion pharmacy. Join us in Simplifying Complex Care!
RN License required.
Soleo Health Perks:<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>
The Position:
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.
Responsibilities include:<ul><li>
Sales Support/Patient Referral: 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>
Patient Coordination: 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>
Nurse Liaison: 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>
Patient/Family Education: 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>
Administrative: 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>
Schedule:
Monday-Friday 8:30am-5pm
Weekends as needed
Requirements:
<ul><li>Bachelor's degree or medical background preferred.</li><li>
RN License 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>
About Us: 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!
Soleo&rsquo;s Core Values:<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>
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.
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.
Keywords: Now hiring, hiring now, immediately hiring, hiring immediately
#INDALL</div>

Clinical Transition Coordinator - RN

Texas Health Resources

<div><div>Care Transition RN
Bring your passion to Texas Health where we are Better +Together
Work location: Texas Health Cleburne 201 Walls Dr. Cleburne, TX 76033
Work hours: PRN Days - Between 8:00 am - 5p to cover sick/pto time. Occasional weekends required(Saturday on site 8am-5p and Sunday can be remote or on site between 8am-5p)</div><div>
Department highlights:
Robust Unit Based Council (UBC) and engaged leadership team<ul><li> The Care Transition team ensures that patients are transitioned to appropriate level of care in a timely and effective manner. Provides education, care and resources to patients across various specialties to identify transition needs and discuss post- acute care options</li><li> Manageable Case Load</li><li> Team that works together to ensure work life balance for all</li></ul>
Here&rsquo;s What You Need
<ul><li> Bachelor of Science in Nursing required. (Individuals hired as CTRN prior to May 11, 2017 will be grandfathered to the CTRN position with an RN, at the entity they were employed at on May 11, 2017)</li><li> 3 years of experience as a staff nurse in an acute care hospital required.</li><li> 1 year discharge planning / care management preferred.</li><li> RN Registered Nurse required upon hire</li><li> CPR &ndash; Cardiopulmonary Resuscitation required upon hire</li><li> ACM &ndash; Accredited Case Manager preferred or</li><li> CCM &ndash; Certified Case Manager or other ANCC upon hire preferred.</li></ul>
Skills<ul><li> Working knowledge of medical necessity criteria preferred</li><li> Knowledge of MS Outlook and Office (Word, Excel)</li><li> Customer Service Skills</li><li> Ability to engage in complex clinical decision -making</li><li> Strong oral and written communication skills</li><li> Strong commitment to interdisciplinary collaboration</li><li> Critical thinking, analysis and conflict resolution skills</li><li> Ability to prioritize and meet deadlines</li></ul>
Position Responsibilities<ul><li> Ensure patients are transitioned to appropriate levels of care in a timely and effective manner to decrease hospital length of stay</li><li> Reviews and works to reduce readmission rates for assigned patients</li><li> Identify high risk patients and promotes discussion and assists in the identification of a primary care physician (PCP) for patients</li><li> Completes Transition Evaluations on patients within 24 hours of identification and begins discharge planning</li><li> Interviews and assesses patients and caregivers as part of the transition evaluation</li><li> Identifies transition needs and discusses funding of post-transition care with patients and caregivers</li><li> Delivers Medicare forms to designated recipients per Medicare guidelines</li></ul>
Additional perks of being a Texas Health Nurse<ul><li> Benefits include 401k, PTO, medical, dental, Paid Parental Leave, flex spending, tuition reimbursement, Student Loan Repayment Program as well as several other benefits.</li><li> Delivery of high quality of patient care through nursing education, nursing research and innovations in nursing practice.</li><li> Strong Unit Based Council (UBC).</li><li> A supportive, team environment with outstanding opportunities for growth.</li><li> Explore our Texas Health careers site for info like Benefits, Job Listings by Category, recent Awards we&rsquo;ve won and more.</li></ul>
Do you still have questions or concerns? Feel free to email your questions to recruitment@texashealth.org. #LI-CR1</div></div>

Care Transition RN - PRN Days

Longevity Health

<div>Join us in transforming healthcare. 


Longevity Health&rsquo;s Statement of Purpose is to improve the health and quality of life of nursing home residents by caring for their unique medical, social, and emotional needs. 


Job Summary:

This role blends hands-on patient care with administrative coordination in long-term care settings. The RN Field Coordinator is instrumental in supporting Longevity Health&rsquo;s Institutional Special Needs Plan (I-SNP), ensuring smooth transitions of care, and educating facility staff on our clinical model. The RN Field Coordinator will travel to various Nursing Homes upon request and assignment by the Market Director of Clinical Services (MDCS). 
Key Tasks and Responsibilities:
<ul><li>
Conduct in-person visits at multiple nursing homes to assist Advanced Practice Providers (Nurse Practitioners) with clinical and administrative tasks.</li><li>
Use facility EMRs to prescreen new enrollees and identify continuity of care needs, including access to external specialists.</li><li>
Collaborate with clinical and operations teams to oversee member appointments and ensure timely communication with providers and facility staff.</li><li>
Support transitions of care, assist with prior authorization requests, and help members access services outside the nursing facility.</li><li>
Communicate with patients, families, and physicians as delegated by nurse practitioners.</li><li>
Lead orientation sessions for new and existing nursing homes to educate staff on Longevity Health Plan model of care.</li><li>
Help initiate telehealth services in newly onboarded facilities, including staff education and follow-up.</li><li>
Maintain proficiency in the Longevity Health Plan electronic medical record system and assist with data entry when needed.</li><li>
Participate in clinical meetings and contribute to hospitalization review sessions.</li><li>
Perform additional responsibilities as assigned by the Market Director of Clinical Services (MDCS), based on caseload and team needs.</li></ul>

Credentials &amp; Coverage:
<ul><li>
Licensed registered professional nurse in good standing.</li><li>
Valid state drivers&rsquo; license with a good driving record and proof of automobile insurance required.</li><li>
Auto insurance coverage as required by your state of residence. New employees will be responsible for providing proof of coverage prior to hire and on an ongoing basis.</li></ul> 


Education and Training:
<ul><li>
Associate degree in nursing required, bachelor&rsquo;s degree in nursing or other healthcare related discipline but must be a licensed professional registered nurse.</li></ul>

Knowledge and Experience:
<ul><li>
Nursing home background or health plan case management experience preferred.</li><li>
Minimum 2 years&rsquo; experience as a Registered Nurse.</li><li>
Excellent verbal and written communication skills.</li><li>
Excellent computer skills, EMR/clinical Platform/MS Office Products.</li><li>
Knowledge of the challenges and opportunities to serve the long-term nursing home population.</li><li>
Able to travel.</li><li>
Required to have managed care coordination background/experience.</li></ul>
Company Overview 
Longevity Health is a national provider of Institutional Special Needs Plans (I-SNP), created to meet the complex healthcare needs of nursing home residents. Since our founding in 2018, we've expanded our services across several states and formed strategic partnerships to deliver high-quality, patient-centered care. We are actively growing, with plans to continue expanding our services across the nation. 


Longevity Health is an Equal Opportunity Employer. We value diversity and encourage applicants of all backgrounds to apply. 


COVID-19 Vaccination Policy

Longevity Health follows federal and state regulations regarding COVID-19 vaccinations. Some facilities may still require staff vaccinations to protect the health of residents. Applicants will be required to provide proof of vaccination, or an approved exemption, where applicable. 


If you are passionate about healthcare and ready to help us drive change in long-term care, apply now to join the Longevity Health team! 


#LHP2026A</div>

RN Field Coordinator

Sentara

<div><div>Sentara Medical Group Clinical Administration is now hiring a Full-time RN Integrated Care Manager.
Hours: 36 hours weekly, dayshift
Location: Remote in Virginia Beach, VA
Overview
Responsible and accountable for the provision and facilitation of comprehensive care coordination services and quality outcomes for patients across the continuum. Promotes effective utilization and monitoring of health services, collaborates and communicates with the healthcare team and patient/caregiver to manage care and transitions. Develops and/or implements a comprehensive care plan based on assessment and evaluation of patient/caregiver needs. Functions in one of the following practice settings: Acute Care, Service Lines, Ambulatory/Community-based, Home Health, and Long-Term Care.
Education
<ul><li>Diploma RN/ADN/BSN/MSN</li>
</ul>Certification/Licensure
<ul><li>RN License - Virginia/Compact/Multistate</li>
<li>Basic Life Support (BLS) required within 90 days from hire</li>
</ul>Experience
<ul><li>RN Nursing experience 3 years required</li>
<li>Case Management experience 3 years preferred</li>
<li>Previous experience with the pediatric population preferred</li>
</ul>Keywords : Integrated Care Manager, RN, Case Manager, Talroo-RN, Monster</div></div>

RN Integrated Care Manager

Brio Living Services

<div><h3 class="jobSectionHeader">Description</h3><div> 
Are you ready to use your nursing expertise to make a real difference every day? 
At PACE of Southwest Michigan, we&rsquo;re more than a healthcare program, we&rsquo;re a community dedicated to helping older adults live their best lives. 
As an RN Clinical Coordinator, you&rsquo;ll play a vital role in bringing that mission to life. 
 
Schedule: Exempt (salaried), min 40 hours/week | Monday - Friday | Generally 8:00 a.m. to 4:30 p.m, with some flexibility depending on the needs of the day 
Department: Clinical Nurse/Homecare | PACE of Southwest Michigan | St. Joseph, MI 
</div><div>What You&rsquo;ll Do:</div><div>
Join a mission-driven team where you&rsquo;ll deliver compassionate, patient-centered care across home, clinic, and partner facilities. As an RN Clinical Coordinator (Registered Nurse), you&rsquo;ll take the lead in managing complex care using PACE-specific assessments, collaborating with a dedicated Interdisciplinary Team to create and execute personalized care plans.</div><h3 class="jobSectionHeader"> 
Key Responsibilities</h3> 
<ul>
<li>
Manage and coordinate care across home, clinic, and partner facilities.</li>
<li>Administer treatments, medications, and procedures in line with care standards.</li>
<li>Use your critical thinking skills to assess, plan, and deliver individualized care.</li>
<li>Collaborate with an Interdisciplinary Team (IDT) to ensure seamless support for participants.</li>
<li>Educate, advocate, and empower participants and families.</li>
<li>Take the lead in transitions of care, urgent situations, and complex health needs.</li>
</ul><div>This isn&rsquo;t just a nursing job. it&rsquo;s a leadership opportunity where you&rsquo;ll have autonomy, variety, and the support of a compassionate team that shares your passion. 
 
The above is a summary of the position, it in no way states or implies that these are the only duties this position will be required to perform. If selected for the position you will receive a full job description.</div> 
<h3 class="jobSectionHeader">
Skills, Knowledge &amp; Expertise</h3> 
<ul>
<li>
Current RN license in Michigan.</li>
<li>At least 1 year of experience with older adults, long-term care, or home care.</li>
<li>Strong assessment, coordination, and leadership skills.</li>
<li>A collaborative spirit and commitment to high-quality, compassionate care</li>
<li>CPR or willing to obtain within 30 days of hire.</li></ul> 
<h3 class="jobSectionHeader">
Job Benefits</h3> 
<ul>
<li>
Competitive Benefits for Full-Time Team Members &ndash; Enjoy Medical, Vision &amp; Dental Insurance starting on the 1st of the month after 30 days of hire.</li>
<li>Retirement Savings Plan &ndash; Secure your future with employer contributions.</li>
<li>Generous 6 weeks of Flexible time off per year&mdash;plus paid holidays on top of that.</li>
<li>Career Growth &amp; Development &ndash; Advance your career with tuition assistance and school scholarships up to $3,000 per semester.</li>
<li>Wellness Program &amp; Reimbursement &ndash; Prioritize your health and well-being, reimbursed 120 a year!</li>
<li>Team Member Referral Bonus Program &ndash; Earn $500 when you bring great people to our team!</li>
<li>Mileage Reimbursement &ndash; Offered for work-related travel.</li>
</ul><div>
 
ACCESSIBILITY SUPPORT
</div><div>Brio Living Services is committed to offering reasonable accommodation to job applicants with disabilities. If you need assistance or an accommodation due to disability, please contact us at loveyourcareer@mybrio.org</div><div>
BRIO LIVING SERVICES IS AN EQUAL OPPORTUNITY EMPLOYER</div><div>
Brio Living Services provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, or genetics in accordance with applicable federal, state and local laws. 
 
#724</div><h3 class="jobSectionHeader"> 
About Brio Living Services
</h3><div>Brio Living Services is a brand dedicated to celebrating the lives of seniors. With a mission to provide care and nurture a sense of community, Brio Living Services offers a wide range of maintenance-free and amenity-rich senior living options. Their continuum of care supports various levels of need, ensuring overall wellness and satisfaction for residents. At Brio Living Services, residents have the opportunity to pursue their passions, interests, and make new friends, creating strong bonds and special memories within their outstanding communities. From independent living to assisted living, skilled care, rehabilitation, memory care, and more, Brio Living Services provides a full range of services to meet residents' needs and desires. With a focus on vibrant aging, Brio Living Services strives to enrich the lives of seniors through their faith-based and non-profit approach. Their dedication to excellence and partnerships with the community make them a trusted choice for senior living. Explore their website to learn more about their communities, watch exciting videos, and join the team of professionals who are committed to making a difference in the lives of others.</div></div>

RN Clinical Coordinator (Registered Nurse)

Complete Care at Fox Hill

<div>MDS Coordinator<ul><li>
Full Time</li><li>
Day Shift</li><li>
Must Have Active RN Registered Nurse Or LPN Licensed Practical Nurse License</li><li>
MDS Experience within a long-term care facility required</li></ul> 
Complete Care at Fox Hill is a pillar in the community of Vernon, CT. We approach every day with one goal: To improve the lives we touch through high-quality healthcare and extraordinary compassion.
Why work for us?<ul><li>
You will have the opportunity to build a career with an established, highly successful organization in a caring and compassionate environment.</li><li>
We are committed to your growth and success.</li><li>
Come join employees who have become family!</li><li>
Work today, get paid today!</li></ul> 
Now Hiring: MDS Coordinator RN LPN Clinical Reimbursement Coordinator 
Responsibilities:<ul><li>
Monitor and guide the completion of resident assessments in a timely manner.</li><li>
Involvement and supervision of inputting MDS assessments.</li><li>
Transmit MDS assessments to the state and obtain receipt of validation.</li><li>
Schedule and facilitate care plan conferences on a quarterly and annual basis.</li><li>
Other duties as assigned by Director of Nursing and Administrator.</li></ul> 
Qualifications:<ul><li>
Strong working knowledge of Case-Mix, Federal Medicare PPS process, and medical reimbursement required.</li><li>
Previous long-term care experience is required.</li></ul> 
License:<ul><li>
Must have an active RN Registered Nurse/LPN Licensed Practical Nurse for the state of CT</li><li>
RAC-CT Certification a positive; but not required</li></ul> 
Complete Care at Fox Hill is an equal opportunity employer.
Now Hiring: MDS Coordinator RN Registered Nurse LPN Licensed Practical Nurse Clinical Reimbursement Coordinator
#LI-GM1
#CC2024
5626
MDS Coordinator RN LPN Clinical Reimbursement Coordinator</div>

Clinical Reimbursement Coordinator MDS LPN RN

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