Care Transition Nurse: Impactful Discharge Coordination

Triple-S; Guaynabo (PR); On-site; USD 52,000 - 76,000; Full time

Job summary

Triple-S is seeking a Registered Nurse to guide Alianza CarePoint members through the transition of care process in Puerto Rico. You will identify discharged members, connect with them for assessments, and coordinate post-discharge appointments with PCPs to ensure continuity of care and overall wellbeing.

You will communicate with the member and caregiver, address barriers to care, and document interventions in accordance with department policies and procedures.

Qualifications

• Bachelor's degree in nursing required.
• 1–3 years clinical experience preferred.
• 1–3 years managed care experience preferred.
• Current Puerto Rico RN license without restrictions.

Responsibilities

• Identify discharged members from the discharge census.
• Contact members to complete assessments ensuring continuity of care and wellbeing.
• Coordinate PCP 7 days post-discharge appointment.
• Follow up before and after appointments to confirm adherence and discuss care.
• Identify member needs and address barriers to care.

Skills

Action Oriented

Collaborates

Customer Delight (Employee)

Instills Trust

Manages Ambiguity

Education

Bachelor's Degree in Nursing

Job description

Triple-S is seeking a Registered Nurse to guide Alianza CarePoint members through the transition of care process in Puerto Rico. You will identify discharged members, connect with them for assessments, and coordinate post-discharge appointments with PCPs to ensure continuity of care and overall wellbeing.

You will communicate with the member and caregiver, address barriers to care, and document interventions in accordance with department policies and procedures.