RN Care Transition Navigator: Reduce Readmissions

Molina Healthcare; United States; Remote; USD 60,000 - 90,000; Full time

Job summary

Molina Healthcare in the United States seeks a Registered Nurse to support care transitions, coordinating discharge planning from hospital to home or other settings, with a focus on reducing readmissions.

The role requires 2+ years health care experience, an active RN license, and the ability to travel locally; you will educate patients and collaborate with interdisciplinary teams to optimize care transitions.

Qualifications

• At least 2 years experience in health care with 1 year in discharge planning, care management or behavioral health.
• RN with active and unrestricted license.
• Valid driver's license, reliable transportation.
• Knowledge of Care Transitions Intervention (CTI) or similar model.
• Background in discharge planning and/or home health.
• Strong communication, organization and problem-solving skills.

Responsibilities

• Follow member through a 30-day program from hospital admission to transitions to other settings to reduce readmissions.
• Collaborate with hospital discharge planners, hospitalists, providers, staff, and family to ensure safe transitions.
• Coordinate care and reassess member needs using the Coleman Care Transition model post-discharge.
• Educate and support medication management, follow-up care, and signs of worsening condition.
• Attend ICT meetings and provide education to non-behavioral health care managers.
• Travel 40-50% local travel as required.

Skills

Verbal communication

Written communication

Time management

Prioritization

Problem solving

Critical thinking

Education

Registered Nurse (RN) license

Tools

Microsoft Office

Job description

Molina Healthcare in the United States seeks a Registered Nurse to support care transitions, coordinating discharge planning from hospital to home or other settings, with a focus on reducing readmissions.

The role requires 2+ years health care experience, an active RN license, and the ability to travel locally; you will educate patients and collaborate with interdisciplinary teams to optimize care transitions.