- Round on patients in identified acute care facilities (emergency department and inpatient and/or collaborate remotely with facility discharge planning teams to assess risk of readmission and transition of care needs post discharge.
- Serves as a key point of contact between the patient, primary care physician and the extended care team through coordination of patient activities and the appropriate utilization of services.
- Assist patients/families/caregivers with navigating the healthcare system by acting as a patient advocate and educating on preferred post-acute care providers (i.e. SNF, Home Care, Palliative Care, and Hospice).
- Facilitate follow up appointment with PCP within appropriate timeframe based on acuity post discharge.
- Collaborate and make recommendations to hospital discharge planner on transition services, and addressing Social Determinants.
- Serve as a supplemental resource for the PCP/Specialist and Hospitalist involved in discharge planning.
- Communicate with PCP and care team on transition planning, barriers, and recommendations for a successful discharge.
- Ensures patient, family and caregiver understanding of the plan including; condition management, medications, tests, referrals, and services.
- Performs other related duties as assigned.
- The duties and responsibilities listed herein are only estimates used as a guide. It is conceivable that an individual in this position may not be required to work 100% of their time on any one of these principle duties for any given length of time. As such, this information will not be used to limit an individual's activity. This holds true for other related duties. Other related duties may require 100% activity individually, and are not specified herein.
- Licensed RN with experienced with caring for patients with multiple chronic conditions.
- Consistently arrives at work, in professional attire, on time and completes all tasks within established time frame.
- Seeks appropriate tasks when primary tasks are completed and assists co-workers as needed.
- Demonstrates adaptability to expanded roles.
- Adheres to all clinic policies and procedures.
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Elderly care nurse
1 week ago
NovaTech Solutions Rossford, United StatesCARE AND TRAVEL IN NURSING - AS A GERIATRIC NURSE (M/F/D) AWAITS YOU IN ROSSFORD: · Work where others go on vacation · As a Work & Traveler (m/f/d) in the field of geriatric nursing, you will get to know various facilities and people and live in the metropolises of Germany. To en ...
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Long Term Acute Care Registered Nurse
2 weeks ago
Vibra Travels Toledo, United StatesVibra Travels is seeking a Registered Nurse with experience in Long Term Acute Care for a 13-week travel contract. The job requires working 36 hours per week, on 12-hour night shifts. The position is open to travel nurses nationwide. · $2,326 per week salary · Competitive hourl ...
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ProMedica Toledo, United States Full timeJob Description: · Sign-On Bonus - **$15,000 Sign-On Bonus Eligible** · *Candidates must be External and have at least 1 year of Registered Nurse experience to be eligible for the Sign-on Bonus. Sign-On Bonus requires a 2 yr commitment to the Organization. · ProMedica Toledo Hosp ...
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ProMedica Toledo, OH, United States Part timeJob Description: Sign-On Bonus - **$10,000 Sign-On Bonus Eligible***Candidates must be External and have at least 1 year of Registered Nurse experience to be eligible for the Sign-on Bonus. Sign-On Bonus requires a 2 yr commitment to the Organization. ProMedica Toledo Hospital i ...
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ProMedica Toledo, OH, United States Part timeJob Description: · This position includes a $10,000.00 Sign on Bonus w/a 2 year commitment to the organization. Sign On Bonus Eligibility to External Applicants ONLY with 1 year RN Acute Care Experience. · ProMedica Toledo Hospital is one of the largest acute-care facilities in t ...
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ProMedica Toledo, United States Part timeJob Description: · This position includes a $5,000.00 Sign on Bonus w/a 2 year commitment to the organization. Sign On Bonus Eligibility to External Applicants ONLY with 1 year RN Acute Care Experience. · ProMedica Toledo Hospital is one of the largest acute-care facilities in th ...
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ProMedica Toledo, United States Part timeJob Description: · Sign-On Bonus - **$10,000 Sign-On Bonus Eligible** · *Candidates must be External and have at least 1 year of Registered Nurse experience to be eligible for the Sign-on Bonus. Sign-On Bonus requires a 2 yr commitment to the Organization. · ProMedica Toledo Hosp ...
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ProMedica Toledo, OH, United States Full timeJob Description: Sign-On Bonus - **$10,00 Sign-On Bonus Eligible***Candidates must be External and have at least 1 year of Registered Nurse experience to be eligible for the Sign-on Bonus. Sign-On Bonus requires a 2 yr commitment to the Organization. ProMedica Toledo Hospital is ...
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ProMedica Toledo, United States Full timeJob Description: · Sign On Bonus Eligible - **$10,00 Sign-On Bonus Eligible** · *Candidates must be External and have at least 1 year of Registered Nurse experience to be eligible for the Sign-on Bonus. Sign-On Bonus requires a 2 yr commitment to the Organization. · ProMedica Tol ...
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ProMedica Toledo, United States Full timeJob Description: · Scope of Service: · The Registered Nurse assesses, plans, implements and evaluates the nursing care provided to a group of patients. This nurse leads the nursing team members in the care as directed by the attending physician and in collaboration with other hea ...
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ProMedica Toledo, United States Full timeJob Description: · ProMedica Toledo Hospital is one of the largest acute-care facilities in the region. Our 794-bed hospital is staffed by more than 4,800 professional healthcare employees who serve a 27-county area throughout northwest Ohio and southeast Michigan. We also have t ...
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ProMedica Toledo, United States Full timeJob Description: · ProMedica Toledo Hospital is one of the largest acute-care facilities in the region. Our 794-bed hospital is staffed by more than 4,800 professional healthcare employees who serve a 27-county area throughout northwest Ohio and southeast Michigan. We also have t ...
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ProMedica Toledo, United States Full timeJob Description: · Sign-On Bonus - **$15,000 Sign-On Bonus Eligible** · *Candidates must be External and have at least 1 year of Registered Nurse experience to be eligible for the Sign-on Bonus. Sign-On Bonus requires a 2 yr commitment to the Organization. · ProMedica Toledo Hosp ...
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ProMedica Toledo, United States Full timeJob Description: · Sign-On Bonus - **$15,000 Sign-On Bonus Eligible** · *Candidates must be External and have at least 1 year of Registered Nurse experience to be eligible for the Sign-on Bonus. Sign-On Bonus requires a 2 yr commitment to the Organization. · ProMedica Toledo Hosp ...
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ProMedica Toledo, United States Part timeJob Description: · This position includes a $10,000.00 Sign on Bonus w/a 2 year commitment to the organization. Sign On Bonus Eligibility to External Applicants ONLY with 1 year RN Acute Care Experience. · ProMedica Toledo Hospital is one of the largest acute-care facilities in t ...
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ProMedica Toledo, United States Part timeJob Description: · This position includes a $10,000.00 Sign on Bonus w/a 2 year commitment to the organization. Sign On Bonus Eligibility to External Applicants ONLY with 1 year RN Acute Care Experience. · ProMedica Toledo Hospital is one of the largest acute-care facilities in t ...
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ProMedica Toledo, United States Full time**Job Details** · **RN / Registered Nurse - Patient Care Supervisor - Delivery - Full Time - Nights ** · This details all the information about the job posting. Share this job as a link in your status update to LinkedIn. **** · Job Title RN / Registered Nurse - Patient Care Su ...
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ProMedica Toledo, United States Part timeJob Description: · This position includes a $5,000.00 Sign on Bonus w/a 2 year commitment to the organization. Sign On Bonus Eligibility to External Applicants ONLY with 1 year RN Acute Care Experience. · ProMedica Toledo Hospital is one of the largest acute-care facilities in th ...
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ProMedica Toledo, United States Part timeJob Description: · This position includes a $10,000.00 Sign on Bonus w/a 2 year commitment to the organization. Sign On Bonus Eligibility to External Applicants ONLY with 1 year RN Acute Care Experience. · ProMedica Toledo Hospital is one of the largest acute-care facilities in t ...
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ProMedica Toledo, OH, US, United States Part timeJob Description: · This position includes a $10,000.00 Sign on Bonus w/a 2 year commitment to the organization. Sign On Bonus Eligibility to External Applicants ONLY with 1 year RN Acute Care Experience. · ProMedica Toledo Hospital is one of the largest acute-care facilities in t ...
transitions of care nurse - Toledo, OH , USA, United States - Toledo Clinic Inc
Description
General Summary:
Under general supervision by ACO Manager & Clinical Operations, the Transition of Care Nurse works with the patient and their family, PCP and other members of the health care team to coordinate care resources and services to improve the quality and effectiveness and decrease the cost of patient care.
Principal Duties & Responsibilities:
Example of Essential Duties:
Required:
Required:
Education:
Associate or Bachelor degree in nursing.
CPR Certified
