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CentraCare ClinicNew
Overview
Provide comprehensive geriatric primary care, including regulatory visits and rounding, across various sub-acute, assisted living, and long-term care facilities. Collaborate with a multidisciplinary team of physicians and advanced practice providers to ensure high-quality patient treatment.
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Compensation
$325,000 - $400,000 / YEAR
Posted
New
American Addiction Centers
Coordinate efficient hospital discharge and transition processes for high-risk patients recently treated in the emergency room. Identify patient and family needs to coordinate internal and external community resources within the first month post-discharge.
$38 - $57 / HOUR
2 days ago
Millennium Physician Group
The counselor guides patients and families through end-of-life care decisions and manages the full hospice referral lifecycle. They serve as the primary clinical contact for hospice partners and coordinate care within a value-based care model.
Salary not listed
7 days ago
Alignment Health
Coordinate safe transitions for patients moving from hospitals or skilled nursing facilities back to their homes. Create individualized discharge plans and collaborate with providers, rehab facilities, and home health agencies.
$85,696 - $128,543 / YEAR
9 days ago
Elevance Health
The role involves delivering patient education and disease management interventions through health coaching for members with chronic diseases. Responsibilities include conducting clinical assessments, implementing care plans, and coordinating with healthcare providers to improve member health outcomes.
11 days ago
Nebraska Medicine
Coordinate patient-centered, interdisciplinary plans of care for patients in acute inpatient settings. Facilitate seamless transitions of care by arranging post-acute facility transfers and in-home support services.
Mayo Clinic
The RN is responsible for coordinating nursing care, including direct patient care, family education, and transitions of care. They operate within the Mayo Clinic Nursing Professional Practice Model to plan, implement, and evaluate all phases of patient care.
27 days ago
Avail Health
Lead the medical track of a hospital-based Care Transitions Program by conducting post-discharge outreach and clinical assessments for Medicare patients. Coordinate referrals and medication reconciliation to prevent readmissions while collaborating with a multidisciplinary team.
$94,000 - $115,000 / YEAR
28 days ago
Serve as the billing provider for 30-day Transitional Care Management episodes, conducting virtual and in-person post-discharge visits for Medicare-age adults. Responsibilities include medication reconciliation, clinical risk stratification, and coordinating handoffs to behavioral health and chronic disease programs.
$137,500 - $172,500 / YEAR
Lead the behavioral health track of a hospital-based Care Transitions Program by conducting post-discharge outreach and assessing social determinants of health. Coordinate community resources and prepare clinical documentation to support Nurse Practitioners in managing complex Medicare patients.
$70,000 - $87,500 / YEAR
The Staff Pad
The Swing Bed Coordinator manages the daily operations of the swing bed program, serving as a liaison between clinical teams, patients, and families. They are responsible for coordinating admissions, discharges, and transfers while ensuring regulatory compliance and efficient resource utilization.
1 month ago
Self Regional Healthcare
The Community Transitions Navigator provides healthcare navigation and coordinates medical home placements to improve health outcomes. They collaborate with multi-disciplinary teams to address social determinants of health and prevent avoidable hospital admissions.
ONSLOW MEMORIAL HOSPITAL
The Transitions Coach facilitates care continuity by coaching patients and caregivers on care plan execution and patient-practitioner communication. The role involves conducting home visits and post-discharge follow-ups to promote health compliance and prevent hospital readmissions.
Brown Medicine
Performs telephonic care coordination for patients transitioning from hospitals or skilled nursing facilities to primary care. Acts as a liaison between healthcare facilities and providers to ensure seamless follow-up and continuity of care.
$74,256 - $148,512 / YEAR
Open Sky Community Services
Residential Counselors support individuals with mental illness or dual diagnosis in group living environments to foster independence. They implement person-centered treatment plans and assist with daily living activities and community integration.
$20 - $22 / HOUR
Devoted Health
Provide telephonic, short-term interdisciplinary care management for high-risk patients within 30 days post-discharge. Coordinate care with providers and community resources to prevent readmission and improve health outcomes.
$85,000 - $100,000 / YEAR
Adventist Health
Acts as a patient advocate to guide individuals through the clinical care system and coordinate post-hospitalization recovery. Monitors high-risk patients, facilitates home health services, and ensures timely follow-up care through collaboration with the healthcare team.
$54 - $74 / HOUR
Liquid Personnel
Deliver high-quality, person-centered social work that empowers adults with care and support needs. Collaborate with families, carers, and multidisciplinary teams to create tailored support plans.
The Social Worker will support young people aged 18-25 with learning disabilities or care and support needs. This role involves working within the Transition and Progression to Adulthood Team to facilitate their transition into adulthood.
£32 / HOUR
The role involves providing high-quality, person-centred social work support to adults with learning disabilities. Responsibilities include undertaking assessments, developing care plans, and safeguarding adults at risk.
