Transitions of Care Program Manager, RN

TalentLNX LLC; Charlotte (NC); Hybrid; USD 100,000 - 120,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

TalentLNX LLC seeks a Transitions of Care Program Manager, RN, to lead a hospital-to-home care coordination program in Charlotte, NC. The role oversees post-discharge outreach, medication reconciliation, and follow-up scheduling across hospital, skilled nursing, and home-health partners, with on-site time at partner facilities.

The ideal candidate has a BSN, an active NC or compact RN license, a CCM credential is preferred, and at least four years in case management or discharge planning.

Qualifications

• BSN preferred; active, unrestricted NC/compact RN license required.
• CCM credential preferred.
• Minimum 4 years of case management, discharge planning, or transitions of care experience.
• Experience leading programs or teams.
• Experience coordinating care across acute and post-acute settings.
• Knowledge of readmission measurement, risk stratification, and CMS programs.
• Familiarity with medication reconciliation and post-discharge follow-up protocols.

Responsibilities

• Lead transitions of care across acute, skilled nursing, and home health settings.
• Define post-discharge outreach model: timing, staffing, escalation.
• Oversee post-discharge medication reconciliation and resolve discrepancies.
• Build follow-up scheduling pathways to confirm appointments before discharge.
• Risk stratify discharges to focus intensive support on high-risk patients.
• Coordinate handoffs between hospital, post-acute, and primary care teams.
• Monitor readmission rates by facility and service line.
• Lead outreach staff and set clear expectations.
• Partner with post-acute facilities on performance reporting.
• Connect patients with transportation, food, and caregiver resources.
• Report program performance and financial impact to leadership.

Skills

Care coordination

Discharge planning

Transitions of care

Program leadership

Readmission risk

Readmission programs

Medication reconciliation

Follow-up scheduling

Risk stratification

Cross-functional collaboration

Education

Bachelor of Science in Nursing

RN license (NC or compact)

CCM credential

Job description

# Transitions of Care Program Manager, RNCare Coordination & Case ManagementCharlotte, North CarolinaOctober 5, 2026$100,000 - $120,000 / yearFull TimeHybridApplication ends: **November 6, 2026**Apply Now### Job Description**Location:** Charlotte, NC (Hybrid)We are seeking a **Transitions of Care Program Manager, RN** to lead a program that supports patients from hospital discharge through their next appointment and builds a safe, well coordinated recovery at home. This position is a full-time, direct hire opportunity based in Charlotte, NC. The role oversees post discharge outreach, medication reconciliation, and follow-up scheduling across acute, skilled nursing, and home health settings, with onsite time at partner facilities.This role is well aligned for an RN leader with a strong background in case management or discharge planning who enjoys building programs that make a measurable difference in patient outcomes. The ideal candidate coordinates confidently across hospital, post-acute, and primary care teams, leads outreach staff with clear expectations, and uses readmission data to continually strengthen the program.**Responsibilities:*** Lead the transitions of care program across acute, skilled nursing, and home health settings* Define the post discharge outreach model, including timing, staffing, and escalation criteria* Ensure post discharge medication reconciliation is completed and discrepancies are resolved* Build follow-up scheduling pathways so appointments are confirmed before the patient is discharged* Risk stratify discharges to focus intensive support on patients with the highest readmission risk* Coordinate handoff communication between hospital, post-acute, and primary care teams* Monitor readmission rates by facility, service line, and discharge disposition* Analyze readmission root causes and refine program interventions based on trends* Lead the nurses and coordinators who conduct post discharge outreach* Partner with post-acute facilities on shared performance expectations and reporting* Connect patients with resources for transportation, food, and caregiver support* Report program performance and financial impact to leadership**Qualifications:*** Bachelor of Science in Nursing preferred* Active, unrestricted North Carolina or compact Registered Nurse license required* Certified Case Manager (CCM) credential preferred* Minimum of 4 years of case management, discharge planning, or transitions of care experience* Prior program or team leadership experience* Experience coordinating care across acute and post-acute settings* Working knowledge of readmission measurement, risk stratification, and CMS readmission programs* Familiarity with medication reconciliation standards and post discharge follow-up protocols**Schedule:*** Full-time position* Hybrid schedule based in Charlotte, NC, with onsite time at partner facilities* Monday through Friday, standard business hours (Eastern Time)* 40 hours per week**Salary Range:** The salary range for this position is approximately $100,000 – $120,000 annually ($48.08 – $57.69 per hour), based on experience and qualifications.**Interview Process:**Selected candidates will participate in a multi-step interview process, including an initial screening with TalentLNX followed by interviews with department leadership.---**Equal Opportunity Employer:** TalentLNX is committed to equal employment opportunity and a diverse, inclusive workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.