Transitions of Care Clinical Advocate RN

 The Transitions of Care Clinical Advocate (RN) will engage Medical Access Program (MAP) patients during the hospital admission phase to support care coordination with Central Health’s network of providers, optimize care navigation and provide patient and caregiver education under a transitions of care program, which will begin with a patient’s hospitalization and extend through the patient’s transition to next care facility and facility teams.Under the supervision of the Transitions of Care Director or designee, the Transitions of Care Clinical Advocate (RN) will work within a hospital setting five days/week, collaborating with MAP patients, discussing their care plans, preparing them for discharge, providing patient education (medication, conditions, follow up care); communicating...