Transition of Care-RN - Region C (Tuscaloosa)
Under the direction of the Clinical Care Supervisor, the Transition of Care-RN will provide ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs.
Responsibilities and Duties
- Collaborate with hospital discharge planners and behavioral health staff in preparations discharge.
- Ensure home based support and services are available.
- Complete a health and psycho-social assessment tool based in case management software and/or other case management system approved by Alabama Medicaid to evaluate patient needs, determine appropriate interventions, and set achievable goals based on an individualized plan of care.
- Review medication lists and work closely with the Pharmacist regarding medication reconciliation.
Qualifications and Skills
- RN, BSN Degree
- Must be licensed in the State of Alabama
- Greater than 2-5 years clinical experience
- Dependable transportation, valid Alabama driver's license and insuance are required.