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Care Transitions Nurse

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Advocate Health Care

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Location:
United States , Milwaukee

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Category:
Nursing

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Contract Type:
Not provided

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Salary:

35.50 - 53.25 USD / Hour
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Job Description:

This will be a 0.5 FTE weekend position. Hours are Saturdays and Sundays, 0800-1830. Fully remote, high- speed internet is a requirement. Occasional holiday must have a WI OR IL RN license. After hire will be required to hold WI and IL RN license.

Job Responsibility:

  • Identifies the needs of patients and families and coordinates internal and external community resources within the first month of hospital discharge to reduce post-hospitalization illness/disease
  • Works closely with case manager to identify high risk patients
  • Creates a care plan to ensure patient has appropriate resources necessary to lower readmission rates
  • Maintains caseload of patients following discharge to ensure patients receive appropriate home visits, are being seen by primary physicians and taking their medications as needed
  • Facilitates communications between and negotiates with patient/family, physicians, nurses, dietary, rehab, homecare, social services and other disciplines that need to collaborate to provide care for the patient
  • Identifies, evaluates and acts to resolve any potential barriers to delivery of care and a timely and appropriate discharge
  • May coordinate and document discharge plans of care
  • Works closely with the medical staff, hospital departments and ancillary services in expediting care delivery and appropriate documentation to avoid delays in timely service provision
  • Validates care that is provided
  • Collaborates as a partner with jointly assigned social worker to ensure safe and appropriate discharge planning
  • Collaborates with physicians daily regarding patient care course
  • Makes suggestions in expediting care and modification to a tentative on a timely basis

Requirements:

  • Registered Nurse license issued by the state in which the team member practices
  • Bachelor's Degree in Nursing
  • Typically requires 2 years of experience in nursing in an acute care or community setting
  • Excellent written and verbal communication skills
  • Strong organizational, analytical and problem solving skills
  • Ability to educate clinical staff and the community
  • Ability to work well with physicians and other healthcare professionals
  • Ability to work in a team based multidisciplinary environment
  • Must be able to sit, stand and walk without restriction
  • Must have the ability to move about in confined spaces, including bending, twisting, kneeling, squatting and occasionally reaching one or both arms overhead
  • Must be able to concentrate on detailed information, tasks, and functions for prolonged periods of time
  • Must be able to speak clearly and hear in order to communicate in person or via telephone
  • Must have a WI OR IL RN license
  • After hire will be required to hold WI and IL RN license
  • Fully remote, high-speed internet is a requirement
What we offer:
  • Paid Time Off programs
  • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
  • Flexible Spending Accounts for eligible health care and dependent care expenses
  • Family benefits such as adoption assistance and paid parental leave
  • Defined contribution retirement plans with employer match and other financial wellness programs
  • Educational Assistance Program
  • Premium pay such as shift, on call, and more based on a teammate's job
  • Incentive pay for select positions
  • Opportunity for annual increases based on performance

Additional Information:

Job Posted:
February 13, 2026

Employment Type:
Parttime
Work Type:
Remote work
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