Remote RN Transition of Care Coach License​/PST

The Remote RN Transition of Care Coach provides support for care transition activities, facilitating coordination for member discharge from hospital to other settings. This role is ideal for nurses who are proactive and detail-oriented, focusing on reducing member readmissions.

• Pay: $23 - $51/hour
• Location: Remote, US
• Schedule: Full Time, Day shift

• Follow members throughout a 30-day program from hospital admission to discharge.
• Collaborate with hospital discharge planners and outpatient providers for safe transitions.
• Ensure adequate caregiving and functional support during member transitions.
• Work with ancillary providers to ensure necessary services and equipment are in place.
• Conduct face-to-face visits with members in the hospital and home visits for high-risk members post-discharge.
• Coordinate care and reassess member needs using the Coleman Care Transition model.
• Educate members on medication management, follow-up care, and advance directives.
• Use motivational interviewing to support and motivate members during contacts.
• Assess barriers to care and provide coordination and assistance.
• Facilitate interdisciplinary care team meetings and collaboration.

• Registered Nurse (RN) License must be active and unrestricted in state of practice.

• At least 2 years in health care, with 1 year in hospital discharge planning or care management.

• Valid and unrestricted driver's license and reliable transportation.
• Knowledge of or experience using the Care Transitions Intervention (CTI) or similar model.

Molina Healthcare is a leading healthcare provider committed to delivering exceptional patient care. They focus on providing quality and cost-effective member care, ensuring that the best possible services are available to their members.