RN Acute Care Transition

2600 White Plains Hospital Medical Center; South Broadway (WA); On-site; USD 106,000 - 130,000; Full time

Job summary

White Plains Hospital Medical Center in White Plains, NY, seeks an experienced Registered Nurse for the Acute Care Transition Team (ACTT). The ACTT RN will coordinate care across the outpatient setting, hospital and home, ensuring smooth transitions and two-way communication between acute care and community resources.

Responsibilities include diagnosis and medication management, outpatient follow-up coordination, post-acute outreach, and data analysis, with a day shift 8:00 AM to 6:30 PM, Monday

Qualifications

• Current New York State RN license and registration.
• BSN required for RNs hired after 1/1/2018; BSN/ MSN by 12/31/2021 for earlier hires.
• 5 years of nursing experience in inpatient/ED or care coordination preferred.
• Strong computer skills with EPIC, MediTech and Midas.
• Ability to type at 50 words per minute.

Responsibilities

• Bridge care from outpatient to hospital and home, ensuring clear two-way communication.
• Engage in diagnosis and medication management, access to care and follow-up coordination.
• Coordinate post-acute care calls, assess social determinants of health.
• Assist with data collection, analysis, and dissemination.

Skills

Communication skills

Leadership

Customer service

Typing speed

Bilingual Spanish

Education

Registered Nurse NY license

BSN for post-2018 hires

BSN/MSN deadline compliance

5 years clinical experience

Proficiency with EHR/EPIC

Tools

EPIC

MediTech

Midas

Outlook

Excel

PowerPoint

Job description

City/State: White Plains, New York Department: Acute Care Transition_1 Work Shift: Day Work Days: MON-FRI, OCCASIONAL WEEKENDS Scheduled Hours: 8 AM-6:30 PM Hours Per Pay Period: 75 Pay Rate/Range: $106,000 - $130,000 For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.

As a key member of the Acute Care Transition Team (ACTT), the Registered Nurse (RN) will work with the other team members to bridge the divide from the outpatient setting to the hospital as well as from hospital to home. The ACTT RN will support the acute care staff that has recently rendered care, our patients, and their family members as they navigate the healthcare system at White Plains Hospital (WPH) and our affiliates. The ACTT RN will help to facilitate two-way communication between the acute clinical setting and the home environment and includes encounters from the emergency department, inpatient setting, observation, labor & delivery, and/or ambulatory surgery.

Some examples of the team’s responsibilities will include but not be limited to:

• Diagnosis management
• Medication management
• Access to care, care linkages and community resources
• Outpatient follow-up coordination both within WPH as well as our affiliates
• Radiology and microbiology follow-up need
• Post-acute care phone calls to assess needs, overall satisfaction, and missed opportunities
• Assessment of social determinants of health that may be inhibiting the journey back to health
• High risk clinical follow-up
• Expedited outpatient testing, ED care, or direct admission/observation
• Incoming transfers

Essential Functions and Responsibilities

1. Understands and adheres to the WPH Performance Standards, Policies and Behaviors
2. The ACTT RN will contact patients within 48-hours of discharge from the acute care setting with the goal of a 100% contact rate. They will serve all patients not initially directed to the ACTT clinician or social worker.
3. They will work to answer general and specific questions in regards to the patient’s medical encounter, lan of care, potential clinical complications, and/or discharge instructions. They will focus on diagnosis management, medication use, and any social determinants of health that may be impeding a return to health. Any medical care/advice provided will be on par with their scope of practice with any other clinical concerns being directed to the ACTT clinician.
4. During these direct conversations, the ACTT RN will also be required to assess the patient experience, collect feedback, and provide service recovery when appropriate.
5. Assist with the collection, analysis, and dissemination of data.
6. When there is an opportunity for other members of the ACTT to assist, there will be a transfer of contact to that co-located team member so that they may be of assistance (i.e. ACTT clinician, social worker, physician referral navigator).
7. Performs all other related duties as assigned

Education & Experience Requirements

1. Registered Nurse with current New York State license;
2. Graduate from an accredited school of nursing with current New York RN license/registration.
3. BSN Required for RNs hired after 1/1/18.
4. All RNs hired before 1/1/18 will be required to have their BSN (or MSN) by 12/31/21.
5. Proof of BSN (or MSN) must be received by Human Resources by 12/31/21 for verification.
6. 5 years of experience as a nurse in an appropriate clinical setting with inpatient, emergency department, or care coordination experience preferred
7. Strong computer skills including but not limited to outlook, word, excel, PowerPoint, EPIC, MediTech and Midas
8. Ability to type at 50 words/minute

Core Competencies

• Demonstrates ability to utilize appropriate software and may be required to document in the medical record
• Demonstrates understanding of customer service and the concept of service quality
• Demonstrates ability to act in a professional capacity and serve as a professional role model
• Demonstrates leadership skills including collaboration and negotiation
• Demonstrates ability to communicate in a professional manner in all interactions
• Demonstrates cultural sensitivity
• Attention to detail
• Independent judgment and decision-making skills
• Ability to adapt to a readily changing environment and requests
• Demonstrates an ethical practice of medicine
• Demonstrates strong, written and verbal communication skills. Establishes two-way communication by utilizing a variety of communication methods, actively listening to ideas and concerns and responding in an appropriate manner.
• Demonstrates ability to retain composure under stress
• Patient engagement training preferred
• Bilingual Spanish preferred

Physical/Mental Demands/Requirements & Work Environment

• May be exposed to chemicals necessary to perform required tasks. Any hazardous chemicals the employee may be exposed to are listed in the hospital’s SDS (Safety Data Sheet) data base and may be accessed through the hospital’s Intranet site (Employee Tools/SDS Access). A copy of the SDS data base can also be found at the hospital switchboard, saved on a disc.
• Ability to remain in stationary position 90% of time.
• Must be able to work in environment with continuous interruptions.
• Demonstrates ability to analyze multidimensional problems into component parts and sort out tasks in priority order to solve the problem.
• Heavy phone use.
• Ability to use computer for extensive periods of time.
• Ability to respond to frequent calls.
• May need to be able to move about inside the office and within the hospital.
• Constantly utilizes/operates computer to access and document information.
• Ability to communicate with patients, families, and hospital employees on telephone and using email. Must be able to exchange accurate information in these situations

White Plains Hospital Medical Center is an equal employment opportunity employer. White Plains Hospital Medical Center will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.

White Plains Hospital is a proud member of the Montefiore Health System, serving as its tertiary hub of advanced care in the Hudson Valley. The Hospital is a 292-bed not-for-profit health care organization with the primary mission of providing exceptional acute and preventive medical care to all people who live in, work in or visit Westchester County and its surrounding areas. White Plains Hospital has outpatient medical facilities across Westchester, including multispecialty practices in Armonk, Hawthorne, Larchmont, New Rochelle, Rye Brook, Scarsdale, Somers, Yonkers and Yorktown Heights; and Scarsdale Medical Group locations in Harrison and Scarsdale. The Hospital is fully accredited by the Joint Commission, and in 2025 received another 5-star rating from the Centers for Medicare & Medicaid Services (CMS) — the highest distinction offered by the federal agency – for the fourth consecutive year. In addition, the Hospital received its third Magnet® designation from the American Nurses Credentialing Center (ANCC), a distinction held by only two percent of hospitals in the country. White Plains Hospital has consistently received the Outstanding Patient Experience Award from Healthgrades®, and in 2025 was awarded an “A” Safety Grade from the Leapfrog Group for the 14th consecutive time.