Role: Registered Nurse on the Acute Care Transition Team
Responsibilities:
Coordinate safe patient transitions from hospital to home or post-acute settings
Assess patient needs and develop individualized care transition plans
Provide education and discharge planning to ensure continuity of care
Collaborate with physicians, social workers, and community providers
Monitor patient outcomes and participate in quality improvement initiatives
Qualifications & Skills:
Valid RN license
Strong assessment, communication, and collaboration skills
Experience in discharge planning, care coordination, or similar settings preferred
Commitment to evidence-based practice and continuous learning