RN Assessment Coordinator: Care Plans & Transitions Lead

Focus Health Network, LLC; East Kittanning (PA); On-site; USD 55,000 - 75,000; Full time

Job summary

Armstrong Rehabilitation & Nursing Center in Kittanning, PA is seeking an RNAC Registered Nurse Assessment Coordinator to ensure high-quality, regulatory compliant care. You will conduct comprehensive assessments, develop care plans, coordinate with physicians and social workers, and oversee transitions between hospital, rehab, and long-term care.

This on-site, full-time role requires PA RN license and MDS experience.

Qualifications

• Current PA-licensed Registered Nurse in good standing.
• 1+ year experience with MDS assessments and reporting.

Responsibilities

• Conduct comprehensive resident assessments of medical, social, and psychological needs.
• Develop and implement individualized care plans.
• Coordinate with physicians, therapists, and social workers.
• Manage transitions between hospital, rehab, and long-term care.
• Monitor progress and adjust care plans as needed.
• Maintain detailed records of assessments, plans, and outcomes.
• Participate in quality improvement and regulatory compliance initiatives.

Skills

Communication

Interpersonal skills

Organizational skills

MDS knowledge

Regulatory compliance

Education

Registered Nurse license (PA)

Job description

Armstrong Rehabilitation & Nursing Center in Kittanning, PA is seeking an RNAC Registered Nurse Assessment Coordinator to ensure high-quality, regulatory compliant care. You will conduct comprehensive assessments, develop care plans, coordinate with physicians and social workers, and oversee transitions between hospital, rehab, and long-term care.

This on-site, full-time role requires PA RN license and MDS experience.