Transitional Care Nurse

Rosaires Care; Wallingford (CT); On-site; USD 68,000 - 98,000; Full time

Job summary

Rosaires Care in Connecticut is seeking a Revisit Nurse to conduct patient follow-up assessments and review care plans to support continuity of care across settings. You will coordinate with multidisciplinary teams to ensure smooth transitions, identify barriers to recovery, and reinforce patient and caregiver education.

The role emphasizes strong clinical assessment, care planning, and clear communication to support families and care teams.

Qualifications

• Registered nurse licensure required.
• Strong clinical assessment and care planning skills.
• Excellent communication and care coordination abilities.
• Compassionate, patient-centered approach.
• Ability to work effectively in a multidisciplinary team.

Responsibilities

• Perform revisit/follow-up assessments
• Review and update care plans as needed
• Coordinate with multidisciplinary care teams
• Support patient transitions between care settings
• Identify barriers to recovery and help address them
• Provide education to patients and caregivers

Skills

Registered nursing licensure

Clinical assessment and care planning

Communication and care coordination

Compassionate, patient-centered

Team-based collaboration

Job description

Revisit Nurse

Conduct patient follow-up assessments and review care plans to support continuity of care across different healthcare settings. Coordinate with multidisciplinary teams to ensure care transitions are smooth, identify barriers to recovery, and reinforce patient and caregiver education.

Key Duties

• Perform revisit/follow-up assessments
• Review and update care plans as needed
• Coordinate with multidisciplinary care teams
• Support patient transitions between care settings
• Identify barriers to recovery and help address them
• Provide education to patients and caregivers

Qualifications & Skills

• Registered nursing licensure
• Strong clinical assessment and care planning skills
• Excellent communication and care coordination abilities
• Compassionate, patient-centered approach
• Ability to work effectively in a multidisciplinary team