<span>RN Transitional Care Coordinator</span>

AdventHealth • Killeen, TX

376d • $76,378 - $114,546

About The Position

The RN Transitional Care Coordinator at AdventHealth Central Texas is responsible for coordinating care for medically complex patients transitioning from inpatient to non-acute settings. This role involves acting as a liaison and coach for patients at risk of readmission, ensuring they understand their care plans, and following up post-discharge to facilitate safe transitions of care.

Requirements

• ASN in nursing or Case Management Certification
• Two years of healthcare experience
• Licensed Registered Nurse

Nice To Haves

• BSN in nursing
• Two years' experience in case management or acute care hospital or similar experience

Responsibilities

• Proactively coordinate care for medically complex patients transitioning from inpatient to non-acute settings.
• Act as a liaison and coach for patients identified as at-risk for readmission.
• Ensure patients understand and adhere to care instructions and encourage self-engagement.
• Follow up with patients post-discharge to ensure safe transitions of care.
• Conduct care management assessments to identify barriers to self-care.
• Collaborate with patients and healthcare teams to enhance patient satisfaction and improve post-discharge outcomes.
• Establish individualized care plans in collaboration with patients and families.
• Communicate with community providers and monitor patients for 30 days post-discharge.
• Participate in interdisciplinary conferences to review clinical assessments.
• Monitor patient compliance and provide advice as needed.

Benefits

• Benefits from Day One
• Paid Days Off from Day One
• Student Loan Repayment Program
• Career Development
• Whole Person Wellbeing Resources
• Mental Health Resources and Support
• Debt-free Education (Certifications and Degrees without out-of-pocket tuition expense)
• Nursing Clinical Ladder Program

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: No Education Listed
• Number of Employees: 501-1,000 employees