Registered Nurse, Transitions of Care, Avenue North, Wilmington, DE, Hybrid

ChristianaCare is currently looking for a full-time Registered Nurse to join our hybrid, Transitions of Care team. This position is mostly remote, with monthly in-person meetings at our Avenue North location in Wilmington, DE. This nurse will be responsible for coordination of care to patients transitioning from acute care to home.

WORK SCHEDULE:

Monday-Friday, day shift

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Demonstrates knowledge & skills necessary to provide care coordination appropriate to pediatric, adolescent, adult, and geriatric patients.
• Works in conjunction with referral sources to identify patients appropriate for hospital follow-up.
• Outreaches to patients within 48 hrs. post-acute discharge to assess immediate needs
• Identifies patient needs and escalates to next appropriate resource as warranted
• Ensures patient has complete understanding of all discharge instructions
• Review of care plan and ensures this is shared with patient as well as patients entire care team
• Schedules any necessary follow-up visits
• Collaborates with other members of the care team
• Provides appropriate patient education, support, and materials to help facilitate informed decision making
• Assess and support treatment adherence including medication management
• Utilizes critical thinking and judgement to ensure patients needs are met
• Supports the work of the LPN
• Participates in process improvement strategies
• Generates and analyzes reports as needed for appropriate management, trend identification and trouble-shooting efforts
• Adheres to company and clinical guidelines to identify, review, assess, and problem solve
• Participates in a relationship-based care approach to care delivery
• Performs assigned work safely, adhering to established departmental safety rules and practices; reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, patients and visitors.
• Performs other related duties as required

EDUCATION AND EXPERIENCE REQUIREMENTS:

• A graduate of a state approved or National League of Nursing accredited School of Nursing
• RN license or eligible for licensure in the states of Delaware, Pennsylvania, New Jersey, and Maryland.
• Two years experience as a RN, Utilization Management or Case Management experience preferred
• BSN preferred; ADN considered with agreement of completion of BSN in 3 years.

Remote Work Opportunities:

Whether a position can be supported for remote work will be assessed based on whether ChristianaCare is able to meet the business requirements of the proposed remote location.

Qualified candidates should apply online and attach a current resume for consideration.

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