Care Transition Nurse

Job Summary:

In direct delivery of patient care, and under the supervision of the VP of Operations, and direct supervision by the Sr Director of Population Health and Care Transitions, the care transition nurse performs patient care functions as approved by the State of Maine Board of Nursing and St. Joseph Hospital policies and procedures. Will work collaboratively with the primary care team, community care managers, home health agencies, and care givers to care for patients across the continuum. The Care Transition Nurse will establish good working relations with members of the outside medical and civic community in order to advocate for patients.

POSITION RESPONSIBILITIES: 

Responsibilities include screening all admitted patients for risk of poor outcome using the HIN Analytics tool and social determinants of health in order to identify patients at high risk for re-admission and poor outcomes.  Operating daily functions as the hub of care for the patient, ensuring all services are aligned across the continuum to provide seamless transition upon discharge while aligning with patients self-identified goals.

Qualifications:

Education: Two-year college (Associate Degree)

Previous Experience: 1 - 3 years of previous RN experience

Licensure: State of Maine RN License or Compact State License

Certifications: BLS

Covenant Health Mission Statement

We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities.

Our Core Values:

•Compassion

We show respect, caring and sensitivity towards all, honoring the dignity of each person, especially the poor, vulnerable and suffering.

•Integrity

We promote justice and ethical behavior, and responsibly steward our human, financial and environmental resources.

•Collaboration

We work in partnership, dialogue and shared purpose to create healthy communities.

•Excellence

We deliver all services with the highest level of quality, while seeking creative innovation.

Applicants, employees and former employees are protected from employment discrimination based on race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age (40 or older), disability, and genetic information (including family medical history).

Comp Range:

Rate of pay displayed reflects the beginning of the pay scale.  At the time of an offer, determination of your offer will reflect your skills and experience as it relates to the position.

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