Care Transition Specialist

6 days ago


Wheat Ridge, Colorado, United States Christian Living Communities Full time
Job Summary

The Care Transition Specialist - Rehabilitation and Nursing plays a vital role in ensuring the seamless transition of residents from skilled nursing facilities to their homes. This position is responsible for facilitating effective care transitions, empowering residents to manage their own care, and promoting improved self-management skills.

About Christian Living Communities | Cappella Living Solutions

We envision a warm and welcoming environment for all residents, team members, family members, and members of our communities – a place of belonging. Our organization prioritizes providing exceptional care and services that enhance the lives of our residents and staff.

Salary Range
$75,400 - $99,200 per year

Key Responsibilities

This role involves coordinating the work of team members to meet resident goals and expectations, performing post-admission screenings to assess residents' current knowledge of disease processes, and developing coaching relationships with residents and relevant stakeholders. The Care Transition Specialist also empowers residents to actively participate in their plan of care, assists them in developing measurable goals, and follows up with required communication, support, and education to reduce the risk of readmission post-discharge.

In addition, this role entails coordinating and evaluating care conferences, care plan updates, and Med A meetings, including discharge planning and rehab and transition goals. The specialist will oversee discharge planning and case management, implement resident education materials and disease management teaching, and ensure effective communication both internally and externally to foster continuity of care.

Requirements

To be successful in this role, candidates must have a strong background in nursing, preferably as a Registered Nurse (RN) or Licensed Practical Nurse (LPN), with at least 2 years of experience in senior services. A Bachelor of Science in Nursing is preferred. Candidates should possess excellent customer service skills, be knowledgeable about state and federal laws and regulations for skilled nursing facility operation, and have experience with computer word processing and database software.

Benefits

Christian Living Communities | Cappella Living Solutions offers a comprehensive benefits package, including health coverage, Health Savings Accounts, retirement plans with matching contributions, dental, vision, disability, and life insurance, as well as a Paid Time Off plan. We value our employees and strive to provide a supportive and inclusive work environment.

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