RN Transitions Care Coach | Home Health & Care Coordination

Hospice of The Bluegrass, Inc.; Hazard (KY); On-site; USD 33,000 - 50,000; Full time

Job summary

Bluegrass Care Navigators seeks a Transitions Care Coach (RN or LPN) to support patients transitioning from hospital to home. You will educate patients and caregivers in homes and community settings, helping manage chronic conditions and reduce hospitalizations.

The role requires conducting home visits with strong communication and organizational skills, and the ability to manage a flexible PRN caseload while adhering to HIPAA policies.

Qualifications

• RN with current, unrestricted license in the state.
• 1–2 years in home health, healthcare, care coordination, or community-based org preferred.
• Strong communication, interpersonal, and organizational skills.
• Ability to engage with patients, families, caregivers, and professionals.
• Knowledge of medical terminology and healthcare processes.
• Experience educating, coaching, and teaching patients.

Responsibilities

• Provide individualized education and support to eligible patients across care settings.
• Build trusting relationships and guide patients toward improved health outcomes.
• Coordinate care, navigate resources, and support transitions.
• Document care activities and patient outcomes; maintain confidentiality.

Skills

Home health experience

Care coordination

Patient education

HIPAA compliance

Excellent communication

Caseload management

Education

Registered Nurse licensure (RN)

Job description

Bluegrass Care Navigators seeks a Transitions Care Coach (RN or LPN) to support patients transitioning from hospital to home. You will educate patients and caregivers in homes and community settings, helping manage chronic conditions and reduce hospitalizations.

The role requires conducting home visits with strong communication and organizational skills, and the ability to manage a flexible PRN caseload while adhering to HIPAA policies.