Care Transition Manager Registered Nurse- Texas Health Resources HEB
Texas Health Resources
Bedford, Texas 76022

Job Description

Care Transition Manager Registered Nurse – GREAT Opportunity!

Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for qualified Case Transition Manager Registered Nurse like you to join our Texas Health family.

Position Highlights

  • Work location: Texas Health HEB 1600 Hospital Parkway TX 76022
  • Work environment: Direct Patient Care
  • Work hours: Full Time 40/hr, Monday-Thursday one week and Tuesday-Friday one week 1pm-11pm, no weekends required.
  • Salary range: $37.17 - $55.05 per hour (based on relevant experience)

Why Texas Health Resources?

At Texas Health HEB we take seriously our mission to improve the health of those in our community. We are a 296-bed, acute-care, full-service hospital serving our community since 1973. Our location in the DFW mid cities provides convenient care to the residents of Hurst, Euless, Bedford and the surrounding areas.

And talk about award winning. Texas Health HEB is Joint Commission-certified in both Heart Failure and Chest Pain, a Primary Stroke Center, a Level III Trauma Center and a designated Baby Friendly facility. We are a top-notch choice in North Texas for emergency services, women's services, cardiac care and much more.

As part of the Texas Health family, we employ over 24,000 employees and are among the areas top five largest employers. Come be a part of our exceptional team as we continue to provide outstanding care and deliver award winning results. You belong here.


  • Bachelor's Degree - Bachelor of Science in Nursing required.
  • Other – CLIAFE – Must comply with CLIA regulations regarding foreign education equivalency required.
  • 3 years of experience in an acute care hospital required.
  • 6 months-1 year discharge planning / care management strongly preferred.
  • ED Experience is strongly preferred
  • RN - Registered Nurse Upon Hire (required) And
  • CPR – Cardiopulmonary Resuscitation required upon hire And,
  • ACM – Accredited Case Manager upon hire preferred or,
  • CCM – Commission for Case Manager Certification or ACM – American Case Management Certification upon hire preferred.
  • Other – ANCC upon hire preferred.

Position Responsibilities Responsible for ensuring patients are transitioned to appropriate levels of care in a timely and effective manner. In addition to the required qualifications, a successful RN will:

  • Reviews the Texas Health Readmission Indicator List (THRIL) scores daily for all assigned patients and collaborates with the interdisciplinary team to identify high risk patients whose THRIL score may not have indicated appropriately.
  • Promotes discussion and assists in the identification of a primary care physician (PCP) for patients without a PCP
  • Completes Transition Evaluations on patients within 24 hours of identification and begins discharge planning.
  • Interviews and assesses patients and caregivers as part of the transition evaluation and as needed.
  • Identifies transition needs and discusses funding of post-transition care with patients and caregivers.
  • Identifies Geometric Mean Length of Stay (GMLOS) and updates the Anticipated Date of Discharge (ADOD) as necessary while considering excess days risk.
  • Identifies community resources and service needs and facilitates appropriate referrals as needed.
  • Assigns patients to and supports appropriate transition programs (e.g. ACO members) when applicable
  • Communicates with the multidisciplinary team (physicians, nursing, therapy), patient, family and post-acute care stakeholders in order to coordinate care.
  • Educates, patients, caregivers, and the multidisciplinary team regarding available post-acute care services and needs.
  • Executes and updates the discharge plan as needed.
  • Communicates final transition plan 24-48 hours prior to transition.
  • Obtains social, physical, psychological and financial histories from available resources. Assesses patient information utilizing medical knowledge. Identifies reasons contributing to patient readmissions.
  • Ensures patients are provided post-acute options based on clinical necessity and patient choice while also considering the payor source
  • Responsible for compliance with documentation guidelines and regulatory agency requirements
  • Compliance requirements for delivery of HINN, second IMM and MOON letters
  • Potential denials, avoidable days, and alternate level of care days
  • Clinical review staff requirements and communications
  • Working knowledge of medical necessity criteria preferred Knowledge of Microsoft Outlook and Office (Word, Excel) Customer service skills Ability to engage in complex clinical decision-making Strong oral and written communication skills Strong commitment to interdisciplinary collaboration Critical thinking, analysis and conflict resolution skills Flexible scheduling as necessary Psychosocial and crisis intervention skills Ability to prioritize and meet deadlines
  • Performs other duties as assigned.

Why Texas Health As a Texas Health RN you'll enjoy top-notch benefits including 401(k) with match, paid time off, competitive health insurance choices, healthcare and dependent care spending account options, wellness programs to keep you and your family healthy, tuition reimbursement, a student loan repayment program and more.

At Texas Health, our people make this a great place to work every day. Our inclusive, supportive, people-first, excellence-driven culture make THPG a great place to work.

Here are a few of our recent awards:

  • 2021 FORTUNE Magazine's "100 Best Companies to Work For®” (7th year in a row)
  • Becker's Healthcare "150 Great Places to Work in Healthcare" (4 years running)
  • "America's Best Employers for Diversity” list by Forbes
  • A "100 Best Workplaces for Millennials" by Fortune and Great Place to Work®

Additional perks of being a THR Employee Health Registered Nurse:

  • Gain a sense of accomplishment by contributing in a teamwork environment
  • Positively impact patients' quality of life
  • Receive excellent mentorship, comprehensive training and dedicated clinical leadership resources
  • Enjoy opportunities for growth

Explore our Texas Health careers site for info like Benefits, Job Listings by Category, recent Awards we've won and more.

Apply Here


Preferred Years Of Experience:

1 Year(s)

Education Required:

4 Year Degree - BN

Employment/Position Type:

Full Time


Date Posted : 09/27/2021