Registered Nurse, RN Care Transition Manager – FT

Texas Health Resources•Bedford, TX

5h•Onsite

About The Position

At Texas Health HEB we’re committed to providing Northeast Tarrant County with a patient and family-centered approach to care. We’re a 296-bed, acute-care, full-service hospital serving our community since 1973. Our location in the DFW mid cities provides convenient care to the residents of Hurst, Euless, Bedford and the surrounding areas. If you’re looking for women’s services, outpatient surgery, oncology, cardiac rehabilitation and emergency medicine, we’ve got it. Plus, we’re an accredited Cycle IV Chest Pain Center, a Level III neonatal intensive care unit and provide nuclear medicine, neonatal intensive care, respiratory therapy and orthopedic medicine. And did we mention our awards? Texas Health HEB is Joint Commission-certified in both Heart Failure and Chest Pain, a Primary Stroke Center, a Level III Trauma Center and a designated Baby Friendly facility. We’re a top-notch choice in North Texas for emergency services, women’s services, cardiac care and much more. As part of the Texas Health family, we employ over 26,000 employees and are among the top five largest employers in the DFW area. Join us and be a part of our exceptional team as we provide outstanding care and deliver award-winning results. You belong here!

Requirements

Bachelor's Degree Nursing
3 years of Staff Nurse at an acute care hospital is required.
Must hold an active RN license - Registered Nurse Upon Hire is required.
CPR – Cardiopulmonary Resuscitation is required upon hire.

Nice To Haves

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.
1 year of discharge planning and/or care management is highly preferred.
ACM – Accredited Case Manager upon hire is preferred OR CCM – Commission for Case Manager Certification or other ANCC upon hire is preferred.

Responsibilities

Responsible for ensuring patients are transitioned to appropriate levels of care in a timely and effective manner.
Completes Transition Evaluations and collects Social Determinants of Health (SDOH) data on patients within 48 hours of identification and begins discharge planning.
Assesses and interviews patient and caregivers as part of this evaluation and as needed.
Reviews the Risk of Unplanned Readmission (RUR) scores daily for all assigned patients.
Assists in the identification of a primary care physician (PCP) for patients without a PCP and attempts to schedule follow up appointments with either a PCP, specialist, clinic, physician or other transitional care visit prior to discharge.