**All the benefits and perks you need for you and your family:** - Benefits from Day One - Paid Days Off from Day One - Student Loan Repayment Program - Career Development - Whole Person Wellbeing Resources - Mental Health Resources and Support - Debt-free Education* (Certifications and Degrees without out-of-pocket tuition expense) - Nursing Clinical Ladder Program* **Our promise to you:** Joining AdventHealth Central Texas is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth Central Texas is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that **together** we are even better. **Schedule:** Full-time **Shift** : Monday – Friday / 8:00am – 4:00pm **Location:** 2201 S. Clear Creek Rd., Killeen, TX 76549 **The community you’ll be caring for:** · Located in the heart of Texas, AdventHealth Central Texas provides care for the citizens of Bell, Coryell and Lampasas counties. · Both AdventHealth Central Texas is committed to reinvesting in the community by offering the services, technologies, and facilities to set the standard with the continually changing healthcare industry. · As a member of our team of more than 1,000 employees you will enjoy competitive salaries, exceptional benefits and opportunities for growth while working in an environment that is centered around our mission of Extending the Healing Ministry of Christ. **The role you’ll contribute:** _The Transitional Care Coordinator (TCC) is responsible for proactively care coordinating and assisting with transitioning medically complex patients from the inpatient setting to non-acute setting, i.e. home, home health, SNF, rehab, assisted living, etc._ _The TCC will act as a liaison and coach for selected patients identified to be at-risk for readmission._ _The TCC will coach the patient, ensure that patients understand and are adhering to instructions, encourage self-engagement with focus on achievement of goals, ensure that critical elements of the care plan developed in one setting are transferred to the next._ _The TCC will follow-up with patients post discharge to ensure safe transitions of care._ **The value you’ll bring to the team:** · Conducts care management assessments on medically complex patients to determine barriers to self-care. · Collaborates with patients and healthcare team to provide a discharge process that enhances patient satisfaction, efficiency of time and resources and improved post-discharge outcomes. · Collaborates effectively with the patient and family to establish an individualized and successful plan of care for each patient, with an emphasis on appropriate services to meet health needs. · Communicates with community providers and follows patient for 30 days’ post discharge. · Participates in interdisciplinary conferences to review clinical assessments · Monitors patient compliance telephonically and is available to provide advise per protocols. Qualifications **The expertise and experiences you’ll need to succeed** **:** **EDUCATION AND EXPERIENCE REQUIRED:** · ASN in nursing or Case Management Certification · Two years of healthcare experience · Licensed Registered Nurse **EDUCATION AND EXPERIENCE PREFERRED:** · BSN in nursing · Two years’ experience in case management or acute care hospital or similar experience This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Central Texas **Schedule:** Full-time **Shift:** 1 - Day **Req ID:** 24043477 We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.