Transitional Care Nurse
Company: Alden Estates of Naperville
Posted on: September 22, 2022
JOB SUMMARY Responsible for overseeing the coordination of care,
day to day operations of the post- acute programs and services to
all transitional care patients. This includes assessing the
effectiveness and the needs of the programs, development, and
planning of services, organizing, and coordinating the
implementation of services, monitoring, and evaluating the
effectiveness and efficiency of the programs and services. The
Transitional Care Nurse is accountable for maintaining compliance
with current federal, state, and local standards, guidelines and
regulations, facility policies, and as directed by Alden Management
Services. QUALIFICATIONS Demonstrated success in external marketing
to physicians, discharge planners and other healthcare referral
Prefer a graduate of a four-year college with one year's experience
in the health care or long-term care field or have an equivalent
combination of education and experience.
Requires excellent communication skills, verbal and written.
Must possess a current, unencumbered license to practice as an RN
or an LPN in the state(s) where facility(s) are located.
Must be knowledgeable of short-term practices and procedures, as
well as some familiarity with laws, regulations and guidelines
pertaining to Long Term care.
Must possess current CPR certificate or become certified within 90
days of employment.
Must be knowledgeable of nursing and medical practices and
Must possess the ability to make independent decisions when
circumstances warrant such action.
Leads and supervises to create a positive working atmosphere.
Committed to improving the quality of life for those we serve and
possess the ability to work in a team environment that is resident
Must have strong interpersonal skills and advanced customer service
Must possess the ability to deal tactfully with patients, family
members, hospital and facility personnel, visitors, government
agencies/personnel, and the general public.
Must possess leadership and supervisory ability and willingness to
work harmoniously with other personnel. PHYSICAL REQUIREMENTS Must
be able to move intermittently throughout the workday.
Must be able to cope with the mental and emotional stress of the
Must possess sight/ hearing senses or use prosthetics that will
enable these senses to function adequately so that the requirements
of this position can be fully met.
Must be in good general health and demonstrate emotional
Must be able to relate well and work with the ill, disabled,
elderly, emotionally upset and at times hostile people within the
Prolonged standing/walking is required.
May be required to lift, push, pull, and move equipment, supplies,
etc., throughout the day.
Is subject to exposure to infectious waste, diseases, conditions,
etc., including exposure to the (HIV) AIDS and Hepatitis B viruses.
ESSENTIAL FUNCTIONS Work collaboratively with internal staff to
share our message of quality care and service.
Understand and be able to communicate the Post-Acute Programs.
Collaborate with Facility Administration in the planning,
coordination, and implementation of a marketing plan.
Networking and communicating with physicians, hospital, case
managers, home health care agencies and other healthcare referral
sources to present facility and Alden information.
Gather patient referrals and evaluate potential patient admissions
that contribute to Alden's overall revenue growth.
Attend and participate in facility marketing meetings.
Review admission referrals in preparation for receiving the
admission and ensuring that the patient is appropriate for the
program and that all programs and services will be promptly
implemented upon admission and collaborates with hospital nursing
staff as needed.
Evaluate and assess patients in the hospital setting prior to
admission to the facility, when applicable to ensure for smooth
hand off from one healthcare setting to another.
Educate the patients, families, or responsible parties about the
transition process into the facility and remain engaged through the
admission process and through discharge to the next level of
Completes customer care phone calls post transition from
Review admission data for tracking and trending post-acute programs
and their referral sources.
Streamline the admission process by acquiring needed information
before the referral is sent to the facility.
Learn with the hospital process for referrals and assist to ensure
a smooth transition to the facility.
Collaborate with facility staff to review patient care goals and
strategies for discharge planning.
Accept and support the Alden Mission, Our Promise, Customer Service
Values and Motto.
Accepts and supports the Administrator and Transitional Care
Support Team philosophy of care.
Assess, Plan, develop, organize, implement, evaluate, and direct
the facility in its post-acute and transitional care programs and
services to ensure quality of care is being rendered.
Sure, that all procedures are followed in accordance with
established post-acute and transitional care processes and
Directly collaborates with employees and instruct staff providing
education and training to promote job knowledge related to
post-acute programs and services.
Identify problems, develop, and implement solutions with the
assistance of the Administrator and the Alden Post-Acute Support
Collaborate with Administrative team with concerns or complaints
from patients, families, staff, outside resources.
Performs other duties as assigned.
Keywords: Alden Estates of Naperville, Naperville , Transitional Care Nurse, Healthcare , Naperville, Illinois
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