Transitions of Care APP — Virtual Post-Discharge Pro

Devoted Health; Milton (MA); On-site; USD 120,000 - 150,000; Full time

Benefits offered by this job

Health insurance

Dental plan

Vision plan

401K

Paid time off

Stock options

Job summary

Devoted Health seeks an experienced Advanced Practice Provider (NP or PA) to lead its Medical Transitions of Care (TOC) program. The role blends initial post‑discharge visits with follow‑up care, while shaping a high‑performing, interdisciplinary team that collaborates with nurses, pharmacists, social workers, and physicians to prevent readmissions.

You will build a comprehensive care plan over 30 days, balancing acute judgment with longitudinal chronic‑care management, and contribute to EHR

Qualifications

• 5+ years of direct patient care with geriatrics and multiple chronic conditions.
• Experience across acute and chronic presentations and care coordination.
• Active professional licenses in RN/APRN or PA; eligible to license in required states within 90 days.
• Experience with post-discharge care, transitions, and telehealth.

Responsibilities

• Perform comprehensive initial TOC visits and post-discharge assessments.
• Conduct acute/virtual urgent TOC visits and determine level of care.
• Manage clinical trajectory across the 30-day window and adjust care plans.
• Participate in interdisciplinary TOC rounds with care teams.
• Foster safe communication and support program culture.
• Contribute to education, quality-improvement projects, and EHR feedback.

Skills

Geriatrics

Chronic disease care

Telehealth visits

Nurse Practitioner license

Physician Assistant license

Job description

Devoted Health seeks an experienced Advanced Practice Provider (NP or PA) to lead its Medical Transitions of Care (TOC) program. The role blends initial post‑discharge visits with follow‑up care, while shaping a high‑performing, interdisciplinary team that collaborates with nurses, pharmacists, social workers, and physicians to prevent readmissions.

You will build a comprehensive care plan over 30 days, balancing acute judgment with longitudinal chronic‑care management, and contribute to EHR