Transitional Care Nurse (Case Manager), Full-Time

Job Description

Job Description

Position Highlights:

• Job Type: Transitional Care Nurse (Case Manager)
• Location: Community Hospital
• Schedule: Full-Time
• Application Deadline: Open until July 6, 2026

Responsibilities:

• Daily inpatient screening and assessment of readmission risk factors to determine appropriateness for transitional care.
• Discharge teaching, including disease teaching, self-care, lifestyle changes, needed medical equipment (such as oxygen, incentive spirometry) and medication reconciliation/education. Uses teach back method to ensure patient and family understanding. Involves family members with discharge teaching.
• Coordinates the monthly case conference between Community Hospital and Rocky Mountain Health Plans, gathering patients and collaborating with Rocky for patient transitions.
• Educates patient regarding Med-to-Bed program, facilitating that connection between patient and outpatient pharmacist, if needed.
• Schedules primary care provider (PCP) appointment for patient after discharge. If the patient has no PCP, the TCRN works with case management to arrange follow-up, or helps patient to fill out application for PCP.
• Follow-up phone call to patients within 72 hours of discharge.
• Ensures discharge summary is sent to post-acute provider within 24 hours of discharge (or as soon as available).
• In the future, may be required to perform non-skilled home visits to patients who have been determined to be readmission risks, up to 2 times, to assess learning and physical needs, as well as to arrange further care if needed.

Requirements:

• Bachelor's Degree in Nursing Preferred, and/or 5 years of healthcare organization experience. Two years of experience in transitional care, nurse navigation, or Case Management preferred.
• Current working knowledge of Rules/Regulations CMS (CoPs), ORYX Core Measures, and accreditation bodies (TJC/DNV) preferred.
• Certified Case Manager (preferred) or willing to obtain within 3 years of employment.

Compensation:

• $39.00 - $44.85 per hour, depending on education and experience.
• Bonus: $5,000
• Discretionary bonuses, relocation expenses, merit increase, market adjustments, recognition bonuses, and other forms of discretionary compensation may be available.

Benefits:

• Medical, dental, vision insurance
• Life Insurance
• Free Parking
• Paid time off
• Education assistance
• 403(b) with employer matching
• Wellness Program
• Additional benefits based on employment status

Additional Information:

• Relocation: Must relocate to Grand Junction, CO 81505 after starting work.
• Work Location: In-person/onsite

Be Extraordinary. Join Us Today!

Community Hospital recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an equal opportunity employer, Community Hospital is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual’s race, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, transgender status, genetic information or veteran status. Community Hospital does not discriminate against any “qualified applicant with a disability” as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.