RN - Clinical Transition Specialist

Seacrest Behavioral Health; Urbana (IL); On-site; USD 70,000 - 95,000; Full time

Job summary

Seacrest Behavioral Health in Urbana, IL seeks an experienced RN Case Manager to oversee patient outcomes during acute hospitalization and coordinate seamless discharge planning.

You will conduct assessments, monitor progress, and ensure safe transitions to post-hospital settings, applying standardized case management components to improve length of stay and readmission metrics.

Qualifications

• RN with a college diploma in nursing and state licensure.
• Certifications: BLS (within 30 days) and ACM (within 3 years).
• Strong communication, coordination, and interdisciplinary collaboration skills.
• Experience in case management, discharge planning, or related healthcare roles preferred.
• Ability to evaluate care effectiveness and facilitate patient-centered outcomes.

Responsibilities

• Act as a liaison with patients, families, and physicians to determine post-discharge care needs.
• Coordinate inpatient to post-hospital care, ensuring timely and appropriate services.
• Document and evaluate care plans, utilization issues, and patient progress.
• Initiate pre- and post-hospital interventions, referrals, and assessments for discharge needs.
• Collaborate with interdisciplinary teams to meet goals related to length of stay and readmission reduction.
• Assess patients' post-discharge requirements, arrange services like DME, home care, hospice, and transportation.
• Participate in daily rounds, department work groups, and follow-up appointments to ensure continuity of care.
• Obtain prior authorizations, review for utilization, and address denials as needed.
• Perform nursing activities including assessment, care planning, monitoring, and education.

Skills

Communication skills

Care coordination

Interdisciplinary collaboration

Education

RN license

BLS within 30 days

ACM within 3 years

Job description

Responsible for managing patient outcomes during acute hospitalization, ensuring proactive assessments, ongoing evaluations, and seamless discharge planning. Facilitates safe transitions from hospital to appropriate care settings, utilizing case management components: assessment, coordination, monitoring, implementation, and evaluation.

Key Responsibilities

• Act as a liaison with patients, families, and physicians to determine post-discharge care needs.
• Coordinate inpatient to post-hospital care, ensuring timely and appropriate services.
• Document and evaluate care plans, utilization issues, and patient progress.
• Initiate pre- and post-hospital interventions, referrals, and assessments for discharge needs.
• Collaborate with interdisciplinary teams to meet goals related to length of stay and readmission reduction.
• Assess patients' post-discharge requirements, arrange services like DME, home care, hospice, and transportation.
• Participate in daily rounds, department work groups, and follow-up appointments to ensure continuity of care.
• Obtain prior authorizations, review for utilization, and address denials as needed.
• Perform nursing activities including assessment, care planning, monitoring, and education.

Qualifications & Skills

• Licensed Registered Nurse (RN) with a college diploma in nursing.
• Certifications: BLS (within 30 days), ACM (within 3 years).
• Strong communication, coordination, and interdisciplinary collaboration skills.
• Experience in case management, discharge planning, or related healthcare roles preferred.
• Ability to evaluate care effectiveness and facilitate patient-centered outcomes.