RN Care Navigator: Discharge & Transition of Care

Hendricks Regional Health; Danville (IN); On-site; USD 65,000 - 80,000; Full time

Job summary

Hendricks Regional Health is seeking a Case Manager to promote optimal social and emotional functioning and facilitate appropriate use of health care and post-acute services. The role centers on patient-centered assessments, discharge planning, and interdisciplinary collaboration to reduce readmissions and improve quality of life.

The position requires a Registered Nurse license in Indiana and a Bachelor’s Degree in Nursing from an accredited program, with broad healthcare experience across

Qualifications

• Bachelor's Degree in Nursing from an accredited college or university.
• Broad responsibility directly related to work experience in clinical, administrative and managerial positions in healthcare or related field.

Responsibilities

• Discharge screening, evaluation, development and implementation of discharge plans with focus on those with complex needs.
• Reassessment of discharge plan and monitoring for changes in condition
• Patient advocacy with support persons and healthcare team if needed
• Interventions and support with family stress and emotional needs as it relates to making appropriate healthcare decisions.
• Crisis intervention/adjustment to illness/bereavement
• Resource brokering (SNF, home care, hospice, infusion, LTAC, DME, etc)
• System integration/continuity of care and interdisciplinary collaboration
• Follow up calls for transitions of care discharge policy; assess patient care needs over the phone and apply interventions.
• Assessment of Social Determinants of Health and ability to understand government programs and assist individuals accessing those programs.
• Provides information and execution of advance directives.

Education

Bachelor's Degree in Nursing

Job description

Hendricks Regional Health is seeking a Case Manager to promote optimal social and emotional functioning and facilitate appropriate use of health care and post-acute services. The role centers on patient-centered assessments, discharge planning, and interdisciplinary collaboration to reduce readmissions and improve quality of life.

The position requires a Registered Nurse license in Indiana and a Bachelor’s Degree in Nursing from an accredited program, with broad healthcare experience across