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LVN Transitional Care

3 months ago

Irvine, United States CarePartners Living LLC Full time

Job Description

Position Overview

Under the supervision of an Advanced Practice Transitional Care Nurse (AP-TCN), the Transitional Care Nurse provides continuity of care throughout a patient’s episode of acute care, from enrollment during hospitalization through a maximum of 90 days post hospitalization. In collaboration with other health care team members, including the patient and family/caregiver, the TCN coordinates and implements the individualized plan of care. TCNs use their clinical judgment to determine the ‘discharge readiness’ of each patient. The Transitional Care Nurse also leads and supports care programs and research, and assists in marketing, business development, outreach, education, quality improvement, and other initiatives as needed.

  • Location: Irvine, CA

  • Work schedule: Monday through Friday, 8:30am – 5:00pm

  • Reports to: Chief Nursing Officer

Essential Functions and Work Responsibilities

Accommodations can be provided for individuals with disabilities.

  • Initiates telephone outreach and is available by phone during office and on-call hours

  • Works independently and keeps Nurse Practitioner and Coordinator informed of patient status.

  • Uses all components of the Transitional Care Model and nursing process including assessment, triage, planning, implementing, and evaluating care to meet the patients' needs.

  • Provides health maintenance, and medication and disease management education to patients and families/caregivers.

  • Collects, organizes, documents, and analyzes data, synthesizing it into understandable information

  • Coordinates continuity of care, prevention and avoidance of complications, and close clinical treatment and management under the direction of the patient's primary healthcare provider(s), assigned Nurse Practitioner, and Registered Nurse.

  • Effectively communicates, problem-solves, and maintains productive and effective interpersonal relationships while effectively prioritizing.

  • Works with outside facilities and agencies on a routine basis, maintaining positive working relationships.

  • Supports patients and their families, and provides compassionate care

  • Reports back to supervising Nurse Practitioner and CNO

Qualifications:
Qualifications

Qualifications

Required

  • Authorization to work in the US

  • Associate degree from an accredited Nursing Program

  • Five (5) or more years as an LVN, preferably in an acute care or home care setting

  • Current CA LVN license

  • BLS

  • English proficiency

  • Computer literacy (i.e. Microsoft Office Suite)

Preferred

  • BSN

  • Bilingual, Vietnamese preferred

  • Public Health and/or Case Management certification

  • Community education experience

Additional Information