Post Acute Care RN Navigator - ACO
Trinity Health•Hartford, CT
•Onsite
About The Position
Be part of the team in our Clinically Integrated Network program based out of Saint Francis Hospital, part of Trinity Health Of New England! Position Purpose Responsible for supporting the implementation of the THOfNE CIN post-acute strategy, including primary oversight of the Medicare Shared Savings Program (MSSP) Three Day Rule Waiver program.
Requirements
- Current RN License in good standing in CT and MA required (assistance provided to obtain secondary State license if needed)
- Bachelor’s degree in nursing required
- Minimum of two (2) years working within an Accountable Care Organization (ACO) or medical group participating in value-based contracts
Nice To Haves
- Minimum two (2) years experience in case management, discharge planning, utilization management, or post-acute care settings preferred
Responsibilities
- Interface with hospitals’ Case Management team to help coordinate the discharge planning of patients
- Collaborate with network SNFs to transition patients from hospital to SNF including planning safe discharge home
- Collaborate with all care team members involved in patients’ hospitalization and SNF admission and ensuring smooth transitions of care and handoffs to care management
- Collaborate with care teams such as acute care, skilled nursing, and home health agencies to effectively manage and transition patients
- Utilize payor and internal reporting sources to identify high-risk patients who may need additional support and/or follow up when discharging home to reduce risk of readmission
Benefits
- Full time 40hr salaried M-F days
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
