What are the responsibilities and job description for the Transitional Care Registered Nurse position at Limestone Medical Center?
Position Summary
The Transitional Care Registered Nurse (RN) is responsible for identifying high-risk patients at critical transition points, including emergency department visits and hospital discharges, and ensuring timely follow-up, care coordination, and engagement in ongoing care services.
This role serves as the primary driver of post-discharge care management and plays a critical role in reducing avoidable hospital utilization, improving patient outcomes, and supporting enrollment into existing Remote Patient Monitoring (RPM) services through partnerships such as Trilogy Health.
Required Qualifications
- Current Registered Nurse (RN) license in the State of Texas
- Minimum of 2–3 years clinical experience (hospital or outpatient)
- Strong knowledge of care coordination and discharge processes
Preferred Qualifications
Experience in:
- Case management or transitional care
- Chronic disease management
- Population health or quality programs
- Familiarity with EHR systems (e.g., CPSI/TruBridge)
- Experience with RPM or care management programs
Skills and Competencies
- Strong communication and patient engagement skills
- Ability to prioritize and manage high-risk patients
- Critical thinking and clinical assessment skills
- Ability to work independently and within a team-based model
- Organizational and documentation proficiency
Pay: From $38.00 per hour
Benefits:
- Dental insurance
- Gym membership
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: In person
Salary : $38