Transitions of Care RN – Bilingual

Responsibilities

• Participating in delivery of patient education and disease management interventions
• Performing health coaching for members across multiple lines
• Conducting behavioral or clinical assessments to identify individual member needs
• Coordinating specific health coaching plans to address objectives and goals
• Interfacing with providers and health professionals to coordinate health coaching plans
• Educating members regarding clinical needs and facilitating referrals
• Using motivational interviewing to facilitate health behavior change
• Monitoring and evaluating effectiveness of interventions and coaching plans

• Requires AS in nursing and minimum of 2 years of condition specific clinical or home health/discharge planning experience
• Current unrestricted RN license in applicable state(s) required
• RN compact license is highly preferred
• BS in nursing preferred
• Prior case management experience preferred
• Bilingual in Spanish is highly preferred
• Experience working with members that have chronic diseases is highly preferred
• Experience working in home health is preferred