Sanford Health - Sioux Falls, SD

posted 4 months ago

Part-time - Mid Level
Sioux Falls, SD
10,001+ employees
Hospitals

About the position

The Care Coordination Transition Manager (CCTM) role at Sanford Health focuses on providing individualized nursing care to complex patients transitioning from hospital to home. The position aims to reduce readmissions by collaborating with a multidisciplinary team, including nurse practitioners and case managers, to coordinate patient care and education. The role is autonomous yet requires strong leadership and organizational skills to manage team functions and advocate for patients' needs.

Responsibilities

  • Provide individualized nursing care utilizing the professional nursing process.
  • Assist with the coordination of patient care across the continuum by collaborating with healthcare professionals.
  • Act as a liaison with the healthcare team and community resources.
  • Manage ambulatory risk registry to identify high and rising risk populations.
  • Conduct pre-visit chart reviews to prepare for comprehensive patient visits.
  • Facilitate patient advocacy efforts and coordinate care with insurance companies and assistance programs.
  • Support quality improvement initiatives in the healthcare delivery system.

Requirements

  • Bachelor's degree in nursing from an accredited program.
  • Minimum of three years' experience in population health, case management, or related fields.
  • Current unencumbered RN license with the State Board of Nursing.
  • CCTM certification required within 18 months of hire, or CCM certification if CCTM is unavailable.
  • Basic Life Support (BLS) certification required within six months of employment.
  • Valid driver's license.

Nice-to-haves

  • Experience in health plan or quality management.
  • Knowledge of healthcare reimbursement models.

Benefits

  • Health insurance
  • Dental insurance
  • Vision insurance
  • Life insurance
  • 401(k) retirement plan
  • Work/life balance benefits
  • Generous time off package
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