RN Care Transitions Navigator — Hospital Discharge

Beth Israel Lahey Health; Massachusetts; On-site; USD 54,000 - 139,000; Full time

Job summary

The RN Case Manager at Beth Israel Deaconess Medical Center, part of Beth Israel Lahey Health, partners with the interdisciplinary team to facilitate safe, timely discharge and efficient patient transitions.

Responsibilities include coordinating care plans, assessing admissions, promoting patient flow, and communicating with patients and families to ensure post-discharge success. Requires MA RN licensure and 3–5 years in acute care.

Qualifications

• RN licensure in Massachusetts is required.
• Bachelor’s degree in nursing or a related healthcare field preferred.
• ACM/CCM/CMAC certifications preferred; BLS required.

Responsibilities

• Reviews cases within 24–48 hours of admission and daily to plan care progression.
• Collaborates with medical team to formulate transition plans and patient flow.
• Completes initial assessments to identify barriers to discharge.
• Navigates care delivery and ensures timely tests, treatments, and consults.
• Communicates the plan of care to the team and patient/caregiver.

Skills

Verbal communication

Written communication

Relationship building

Negotiation

Education

RN licensure in Massachusetts

Bachelor’s degree in nursing or related field

ACM

CCM

CMAC

BLS

Job description

The RN Case Manager at Beth Israel Deaconess Medical Center, part of Beth Israel Lahey Health, partners with the interdisciplinary team to facilitate safe, timely discharge and efficient patient transitions.

Responsibilities include coordinating care plans, assessing admissions, promoting patient flow, and communicating with patients and families to ensure post-discharge success. Requires MA RN licensure and 3–5 years in acute care.