Transitional Liaison Registered Nurse

Jobtailor; Fort Wayne (IN); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Jobtailor is seeking a compassionate Registered Nurse to identify hospice-eligible patients in Fort Wayne, IN. This hybrid role combines in-office care coordination with remote patient assessments to ensure smooth referrals and admissions.

You will work with care teams to assess needs, educate families about hospice options, and support transitions. A valid Indiana RN license and 3+ years in clinical care are required; hospice/home health experience is preferred.

Qualifications

• Current State license as a Registered Nurse.
• Graduate of an accredited nursing program (Certificate, Diploma, Associate or Baccalaureate).
• 3+ years’ experience in a clinical care setting.
• Experience in Home Health or Hospice is preferred.

Responsibilities

• Identify patients who may qualify for hospice care.
• Follow the hospice referral, admission, and documentation process.
• Assess patients' physical, emotional, social, and spiritual needs.
• Work with care teams to coordinate patient transitions and services.
• Meet with patients and caregivers to discuss care goals and complete initial assessments.
• Explain hospice services so patients and families can make informed decisions.
• Educate staff and referral partners on hospice eligibility and the transition process.
• Work on a hybrid schedule of 3 days in office and 2 days remote.
• Report to the Transitional Care Team Lead.

Skills

Registered Nurse License

Clinical Care Experience

Hospice Care Knowledge

Patient Assessment Skills

Care Coordination

Education

Certificate, Diploma, Associate’s or Bachelor's Degree in Nursing

Job description

• Identify patients who may qualify for hospice care
• Follow the hospice referral, admission, and documentation process
• Assess patients' physical, emotional, social, and spiritual needs
• Work with care teams to coordinate patient transitions and services
• Meet with patients and caregivers to discuss care goals and complete initial assessments
• Explain hospice services so patients and families can make informed decisions
• Educate staff and referral partners on hospice eligibility and the transition process
• Work on a hybrid schedule of 3 days in office and 2 days remote
• Report to the Transitional Care Team Lead

Requirements

• Current State license as a Registered Nurse
• Graduate of an accredited Certificate, Diploma, Associates or Baccalaureate School of Nursing
• 3+ years’ experience in a clinical care setting
• Experience within Home Health or Hospice is preferred

Core Competencies

Demonstrates expertise in patient assessment and care coordination within hospice settings, ensuring compliance with referral and admission processes while effectively communicating with patients and families about care options.

Highest-signal resume keywords

• Registered Nurse License
• Clinical Care Experience
• Hospice Care Knowledge
• Patient Assessment Skills
• Care Coordination

Hard Skills

• Patient Assessment
• Care Coordination
• Documentation Process
• Hospice Eligibility Education
• Initial Assessments

Soft Skills

• Communication
• Empathy
• Team Collaboration

Certifications & Qualifications

• State License as a Registered Nurse

Industry Keywords

• Hospice Care
• Home Health
• Patient Transition
• Care Goals
• Clinical Care Setting