Transitions of Care Nurse

SUMMARY

• Performs telephonic care coordination for patients after an emergency room, hospital inpatient, and/or skilled nursing facility discharge to facilitate continuity of care within our PCMH organization. The Registered Nurse is responsible for facilitating t Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done.
• The core
• Success
• Factors include: Instill Trust and Value Differences
• Patient and
• Community
• Focus and
• Collaborate
• RESPONSIBILITIES: Collaborates with physicians, advanced practitioners, pharmacists, nurses, hospitals, nursing homes and home care personnel in the process of providing coordinated care transition services for patients Acts as a liaison between key contacts at health care facilities and primary care practice Assists patients in making a seamless care transitions by providing timely follow up after discharge and communicating with the care team Performs telephonic outreach to patients to ensure the proper and most effective follow up of discharge plan of care including review of discharge summary provided by hospital or skilled nursing facility and the review of post care instructions as outlined with patient Effectively communicates with appropriate disciplines involved in the care of patients, and provides information and recommendations to providers Develops professional working relationships with health care providers and facilities, generating an open flow of information and support of home care goals; provides value added counsel, teaching and resourceful problem solving Determines individual patient needs for services, referrals and training and provides patient education as necessary on discharge plan of care Promotes effective working relationships with nursing personnel, the management team and health care providers Mentor medical assistant/specialists on the Transitions of Care Team
• Additional responsibilities as deemed necessary
• MINIMUM
• QUALIFICATIONS: Licensure as Registered Nurse in the State of Rhode Island by the Rhode Island Board of Nursing or licensure as a Registered Nurse in accordance with the Nurse Licensure Compact agreement of the National Council of State Boards of Nursing.
• Pay
• Range: $74,256.00-$148,512.00
• EEO
• Statement: Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Location

• Brown Health Medical Group Primary Care - 593
• Eddy
• St -
• Executive
• Suite
• Providence,
• Rhode
• Island 02903
• Work
• Type:
• M-F 730am-4:00pm
• Work
• Shift:
• Day
• Daily
• Hours: 8 hours
• Driving
• Required: No As Rhode Island's largest health system and private employer, Brown University Health is the state's premier provider of health services and includes the only Level I Trauma Center for southeastern New England. Today, more than 20,000 people work at Brown University Health and bring their unique skills, experiences, and compassion to their jobs every day. Formed in 1994, Brown University Health is a not-for-profit health system based in Providence, RI comprising three teaching hospitals of
• The
• Warren
• Alpert
• Medical
• School of
• Brown
• University: Rhode Island Hospital and its Hasbro Children's; The Miriam Hospital; and Bradley Hospital, the nation’s first psychiatric hospital for children; Newport Hospital, Saint Anne's Hospital and Morton Hospital, community hospitals offering a broad range of health services; Gateway Healthcare, the state’s largest provider of community behavioral health care; and Brown Health Medical Group, the largest multi-specialty practice in Rhode Island. Brown University Health is an equal opportunity employer that values diversity of cultural background, race, gender, age, religion, identity, ability, and perspectives - we are actively committed to a diverse workforce that represents the patients and community that we serve. We are invested in creating a respectful, inclusive, and equitable environment that supports the holistic well-being of our employees and their families. Join us and help build a healthier future for our patients - and for yourself. Company Location Belonging and Engagement Nursing Our Mission