Care Transitions RN

Summary

GENERAL SUMMARY :

The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial and utilization coordination of the patients hospital experience. Proactively consults with the interdisciplinary team which includes but is not limited to hospital patient care staff, physicians, patient support and family and community resources to assure a smooth transition for the patient through appropriate levels of care in order to facilitate quality outcomes.

PRINCIPAL JOB FUNCTIONS :

• Commits to the mission, vision, beliefs and consistently demonstrates our core values.
• Utilizes clinical skills to create and update personalized transitional care plans for patients.
• Performs transition planning activities at onset and throughout the patients hospitalization.
• Collaborates with the patients provider and other healthcare team members in managing the patients length of stay and determining the appropriate level of care for transition planning.
• Assists in identifying need for supportive counseling or post discharge extended psychosocial therapy and consults with attending Physician for referral to appropriate provider.
• Maintains awareness of financial reimbursement methodology, utilization management, payer / reimbursement practices and regulations and participates in resource stewardship.
• Promotes quality improvement initiatives and health care outcomes based on currently accepted clinical practice guidelines and total quality improvement initiatives.

EDUCATION AND EXPERIENCE :

Current Registered Nurse licensure from the State of Nebraska or approved compact state of residence as defined by the Nebraska Nurse Practice Act. Minimum of two (2) years recent clinical experience required. Prior care coordination and / or utilization management experience preferred. Basic Life Support (CPR) certification required.

ACUTE REHABILITATION

ADDITIONAL JOB FUNCTIONS :

In addition to the principal job functions contained on the primary job descriptions, the following duties are also required in the department noted above.

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party and managed care contracts, and authorization for post-acute services.

EMERGENCY DEPARTMENT

ADDITIONAL JOB FUNCTIONS :

In addition to the principal job functions contained on the primary job descriptions, the following duties are also required in the department noted above.

rd

party and managed care contracts; discharge planning; and length of stay.

UTILIZATION MANAGEMENT

ADDITIONAL JOB FUNCTIONS :

In addition to the principal job functions contained on the primary job descriptions, the following duties are also required in the department noted above.

rd

party and managed care contracts; discharge planning; and length of stay.