Remote Transitional Care RN: Part-Time 20h/Week

Hugh Chatham Health, Inc.; Milwaukee (WI); Remote; USD 53,000 - 79,000; Part time

Benefits offered by this job

Health benefits

Paid Time Off

Educational Assistance Program

Retirement plans

Job summary

Advocate Health is seeking a part‑time, fully remote RN (BSN) to lead transitional care for high‑risk patients after discharge. The role emphasizes comprehensive assessments, care coordination, and education for patients and families.

Expect collaboration with physicians, pharmacists, social workers, and home health teams. The position requires an active RN license, a BSN, and at least five years in acute or transitional care with a focus on complex patient populations.

Qualifications

• Must have BSN and active RN license.
• Minimum five years clinical nursing experience in acute/discharge/post‑acute or transitional care.
• Experience educating patients with complex needs and coordinating care in multidisciplinary teams.

Responsibilities

• Conduct comprehensive clinical assessments of high‑risk patients at discharge and during 30‑day transitional care.
• Develop and update patient‑centered care plans including meds and follow‑up.
• Coordinate care across inpatient, primary care, specialists, home health, and community resources.
• Educate patients and families on disease management and escalation protocols.
• Manage caseload with follow‑ups, home visits, and adherence to treatments.
• Lead interdisciplinary rounds and collaborate with care teams.
• Document accurately to meet CMS guidelines and organizational policies.
• Participate in quality improvement initiatives.

Skills

Clinical nursing expertise

Care coordination

Communication skills

Telehealth knowledge

Documentation proficiency

Education

BSN

Job description

Advocate Health is seeking a part‑time, fully remote RN (BSN) to lead transitional care for high‑risk patients after discharge. The role emphasizes comprehensive assessments, care coordination, and education for patients and families.

Expect collaboration with physicians, pharmacists, social workers, and home health teams. The position requires an active RN license, a BSN, and at least five years in acute or transitional care with a focus on complex patient populations.