RN Care Transitions Navigator

Molina Healthcare; Fitchburg (MA); On-site; USD 41,000 - 83,000; Full time

Job summary

Molina Healthcare is seeking a Nurse Care Transition Specialist to support care transitions from hospital to home or other settings. You will coordinate discharge planning, collaborate with hospital staff, providers, families and community resources, and monitor patients to reduce readmissions under a 30-day program.

You will perform face-to-face visits, travel up to 40-50% depending on state requirements, educate members on medication management and follow-up care, and participate in

Qualifications

• Active RN license in state of practice.
• 2+ years in health care with discharge planning or care management.
• Knowledge of Care Transitions Intervention (CTI) or similar model.

Responsibilities

• Backbone to hospital discharge planning and 30-day transition follow-up.
• Coordinate care with hospital staff, providers, and family for safe transfers.
• Monitor members and reduce readmissions through structured transitions.
• Attend ICT meetings and educate members on meds, follow-up care, and resources.

Skills

RN license

Discharge planning

Care management

CTI knowledge

Communication skills

Job description

Molina Healthcare is seeking a Nurse Care Transition Specialist to support care transitions from hospital to home or other settings. You will coordinate discharge planning, collaborate with hospital staff, providers, families and community resources, and monitor patients to reduce readmissions under a 30-day program.

You will perform face-to-face visits, travel up to 40-50% depending on state requirements, educate members on medication management and follow-up care, and participate in