Transition of Care Nurse

4 weeks ago


Worcester, Massachusetts, United States Family Health Center Full time

Job Summary:


The Care Coordinator RN at Family Health Center plays a vital role in ensuring a seamless transition for patients from hospital to home. As a key member of the Transitions of Care Team, this nurse is responsible for managing high-risk patients and developing comprehensive care plans to prevent hospital readmissions and improve patient outcomes.



Key Responsibilities:



  • Collaborate with healthcare teams to develop individualized care plans, considering patient medical conditions, medications, and treatment plans.
  • Provide patient education on care plans, medications, and follow-up care to ensure understanding and compliance.
  • Review and update medication lists, addressing discrepancies and potential interactions to ensure safe medication management.
  • Act as a liaison between healthcare providers, ensuring timely communication of relevant medical information.
  • Coordinate follow-up care, including scheduling appointments and services, and advocating for patient needs and preferences.


Requirements:



  • Graduate of an accredited school of nursing, with a BS in Nursing preferred.
  • Two years of full-time professional experience or part-time equivalent.
  • Current RN or LPN licensure in Massachusetts and BLS certification.


About Family Health Center:


Family Health Center is a leading healthcare provider, committed to delivering high-quality care and improving patient outcomes. As a member of our team, you will have the opportunity to make a meaningful difference in the lives of our patients and contribute to our mission of providing exceptional healthcare services.



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