RN Care Transitions Navigator

Carle Health; Illinois; On-site; USD 50,000 - 80,000; Full time

Job summary

Carle Health is seeking an RN Case Manager to oversee the clinical and financial outcomes of hospitalized patients. You will assess, coordinate, monitor, implement, and evaluate care plans, ensuring safe discharge and appropriate post-acute placement.

Collaboration with physicians and care teams is essential to reduce readmissions. Responsibilities include discharge planning, documentation, and patient/family education while navigating post-hospital needs and regulatory considerations.

Qualifications

• Certified: Licensed Registered Nurse (RN) – Illinois
• Education: Bachelor's Degree in Nursing
• Work Experience: (as stated)

Responsibilities

• Liaison with patient/family and physician to determine next level of care
• Coordinate transition from inpatient care to post-hospital care
• Document plan of care and utilization issues in appropriate systems
• Evaluate plan of care effectiveness and collaboration with physicians to reduce readmission risk
• Arrange DME, home care, outpatient infusion and coordinate with social work for hospice, transportation
• Attend patient/family care conferences and participate in multidisciplinary rounds

Job description

Carle Health is seeking an RN Case Manager to oversee the clinical and financial outcomes of hospitalized patients. You will assess, coordinate, monitor, implement, and evaluate care plans, ensuring safe discharge and appropriate post-acute placement.

Collaboration with physicians and care teams is essential to reduce readmissions. Responsibilities include discharge planning, documentation, and patient/family education while navigating post-hospital needs and regulatory considerations.