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RN Transition Coach Per - Diem
- Job Title
- RN Transition Coach Per - Diem
- Job ID
- 710555
- Begin Date
- 5/10/13
- Duration
- Location
- Dallas, TX
- Other Location
- Description
-
JOB SUMMARY: The Transition Coach is the primary coordinator of care beginning with discharge planning from the hospital, managing all care and services for the transition home and monitoring and managing care for the patient for the next 60 days post discharge. The Transition Coach collaborates with physicians, nurses, social workers, discharge planners, pharmacists and other members of the health care team to implement a plan of care that increases the patients’ and caregivers’ ability to manage their care.ESSENTIAL FUNCTIONS
Title: Transition Coach FLSA: Exempt - In hospital assessment and collaboration with hospital team to begin a plan of care.
- Responsible for the completion of in home comprehensive assessments including general health assessment (GHA), collection of observable data and medication reconciliation.
- Assure follow up medical care and coordinate plan of care with primary care provider.
- Establish a plan of care with the patient, caregiver and health care team.
- Telephonic support to assigned patients.
- Enhance communication and collaborative relationships with multidisciplinary team members.
- Active engagement of the patient, caregiver and informal caregivers including education, support and self management skills.
- Monitors health needs and coordination of community resources.
- Identify and arrange ancillary services needed in the home.
- Other duties as assigned.
Minimum Qualifications- Current RN Licensure in the state of TX
- Minimum of 5 years clinical nursing experience.
- Strong professional level of knowledge and comprehensive clinical assessment skills in the adult population and chronic disease management
- Excellent communication skills
- Maintains current CPR certification
Ability to work in a start up environment, requiring innovation and adaptable to change.
- Openings
- 1
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Univita Health is an Equal Opportunity Employer (EOE/AA) and participates in E-Verify. Univita Health will not discriminate in its employment and employment-related decisions against any applicant or employee based on age, race, gender, creed, religion, national origin, disability, marital status, covered veteran status, sexual orientation, status with respect to public assistance, membership or activity on a local commission, or any other characteristic protected under state, federal, or local law.
