Pool Care Transition Registered Nurse - TGH Ambulatory Care Transitions

Tampa General Hospital; Tampa (FL); On-site; USD 75,000 - 95,000; Full time

Job summary

Tampa General Hospital in Tampa, FL is seeking a Pool Care Transition Registered Nurse to join the Ambulatory Care Transitions team. Under general supervision, you will educate patients, coordinate care transitions, and support plan of care compliance, including RPM, home health, DME, and pharmacy in collaboration with physicians.

The role requires a BSN, RN licensure, and at least 3 years of nursing experience in care coordination or ambulatory/post-acute settings.

Qualifications

• Bachelor's Degree in Nursing required.
• Current RN license required.
• Minimum 3 years nursing experience in care coordination, ambulatory, post-acute, or transitional care settings.

Responsibilities

• Serve as point of contact and clinical leader for staff and administration.
• Educate patients and families on transitioning from active treatment to self-management.
• Coordinate Home Health, RPM, DME, Pharmacy as needed and communicate with physicians.
• Develop plan of care and document findings.
• Provide supervision to the Care Transitions Tele Med-Assistant and give performance input.

Skills

Nursing

Care coordination

Ambulatory care

Patient education

Communication

EMR proficiency

Education

Bachelor's Degree - Nursing

Registered Nurse (RN)

Tools

EMR systems

Job description

Job Description - Pool Care Transition Registered Nurse - TGH Ambulatory Care Transitions (260003A4)

Job Description

Pool Care Transition Registered Nurse - TGH Ambulatory Care Transitions - ( 260003A4 )

Description

Under general supervision, provides patient education, support, and interventions to optimize care transitions. Assists in Plan of Care compliance. Includes coordination of Home Health, Remote Patient Monitoring (RPM), Durable Medical Equipment, Pharmacy as needed and communication with physicians. Uses a process of nursing intake, assessment, planning, and care in accordance with physician orders, the established plan of care, the patient’s diagnosis, policies and procedures, and the Nurse Practice Act.

*Required to work every other weekend*

Essential Functions

• Serves as point of contact, clinical leader and resource to staff and administration.
• Provides patients and family with needed information for the transition from active treatment to managing their condition independently.
• Functions as a member of an inter-disciplinary team, encouraging and maintaining open communications.
• Provides clinical supervision to the Care Transitions Tele Med-Assistant for patients and provides input regarding his/her performance to the appropriate manager.
• Assists in the orientation of new staff or continuing education of existing staff as requested.
• Helps to identify patients who are appropriate for RPM.
• Establishes vital sign parameters, obtains physician orders, develops a plan of care, and documents findings.
• Develops and maintains rapport with patients and caregivers via phone and/or video communication.
• Responsible to continually assist patient/family through the healthcare system which includes during procedures/admissions at TGH, follow up, and with community resources.
• Assesses and evaluates patient data and needs; providing appropriate support. Patient/family health education, direction, and intervention.
• Notifies physician and other care agencies of changes in patient condition or status, sends reports, obtains new orders, and modifies the care plan as needed.
• Identifies the need for and recommends appropriate disciplines and community resources for optimum patient care.
• Maintains clinical skills within nursing practice norms and participates in group projects, training, and education as needed.
• Informs department manager of perceived problem areas related to program, patient care, or community relations.
• Demonstrates a professional attitude, sound judgment and continuity in interactions with physicians, other health care providers, and community agencies.
• Acquires and utilizes knowledge of community resources.
• Demonstrated clinical, interpersonal and communication skills.

• Bachelor's Degree - Nursing
• Registered Nurse
• Minimum of three (3) years of nursing experience, including experience in care coordination, ambulatory, post-acute, or transitional care settings.

Technical Knowledge, Skills, and Abilities

• Knowledge of care transition principles, chronic condition management, and ambulatory workflows.
• Ability to assess patient needs, coordinate multidisciplinary care, and support plan-of-care compliance.
• Strong communication and interpersonal skills to engage patients, caregivers, and care teams.
• Ability to manage multiple patients and priorities in a fast-paced clinical environment.
• Proficiency with electronic medical record systems and clinical documentation standards.

Primary Location

Tampa

Work Locations

TGH Main Campus 1 Tampa General Circle Tampa 33601

Eligible for Remote Work : On Site

Job

Ambulatory

Shift

Day Job

Job Type

On Site

Shift Hours : 0730-1800, every other weekend