RN Care Transition Navigator

Socket.dev; Lanham (MD); On-site; USD 48,000 - 69,000; Full time

Benefits offered by this job

Medical, Dental, and Vision Insurance

Retirement Plan (employer match)

Paid Time Off

Tuition Assistance Benefits

Employee Referral Bonus Program

Paid Holidays, Disability, and Life/AD

Wellness Programs

Employee Assistance Programs

Job summary

Luminis Health seeks a Case Manager to coordinate patient care across the continuum, guiding transitions and ensuring timely, appropriate levels of care using evidence-based guidelines. You will work with a multidisciplinary team to assess needs, plan services, and support patients and families in navigating post-acute options.

Requirements include a BSN or ADN with equivalent experience and current Maryland RN licensure; three years of clinical experience and care coordination preferred.

Qualifications

• BSN or ADN with equivalent experience; BSN must be achieved within 5 years.
• Three years of clinical experience in ambulatory or post-acute care.
• Care coordination experience preferred; RN licensure in Maryland required.

Responsibilities

• Identify and prioritize patients needing care management using a biopsychosocial approach.
• Promote engagement, self-care, and adherence using motivational interviewing.
• Verify appropriate level of care and document actions in Epic.
• Develop transition plans for discharge to home or post-acute care.
• Maintain accurate patient records reflecting needs and services.

Skills

Motivational interviewing

Care coordination

Documentation

Interdisciplinary collaboration

Risk assessment

Education

BSN or ADN with equivalent experience

RN licensure Maryland

BSN within 5 years

Tools

Epic

Job description

Luminis Health seeks a Case Manager to coordinate patient care across the continuum, guiding transitions and ensuring timely, appropriate levels of care using evidence-based guidelines. You will work with a multidisciplinary team to assess needs, plan services, and support patients and families in navigating post-acute options.

Requirements include a BSN or ADN with equivalent experience and current Maryland RN licensure; three years of clinical experience and care coordination preferred.