ACUTE INPATIENT TRANSITIONAL CARE MANAGER CARE CONTINUUM MANAGEMENT

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The Transitional Care Manager (TCM) coordinates care for risk contract patients and helps guide them through the transition from one level of care to another. The goal is to optimize patient care transitions, reduce unnecessary utilization of services, and decrease the risk of readmissions.

Roles Responsibility
Conduct comprehensive assessments, Engage interdisciplinary teams, Identify appropriate care sites, Support smooth transitions, Monitor patient progress, Identify high-risk patients, Serve as a clinical liaison, Participate in program development, Facilitate coordination across care levels, Evaluate and monitor patient care plans, Document patient interactions, Participate in meetings, Review program outcomes.
Desired Qualification
BSN Bachelor of Science in Nursing
Type
Full Time
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