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About Our Company
Vytalize Health is a leading provider of value-based care for Medicare patients. We power independent primary care practices through bold financial incentives and smart technology. We are on a mission to accelerate the world’s transition to value-based care by taking care of the doctors who take care of us. We are the fastest growing value-based care provider in the country spanning 14 states and more than 1,000 PCPs.
Visit www.vytalizehealth.com for more information.
Job Description
Vytalize Health is currently looking for an experienced Transitional Care RN Case Manager to coordinate our patients’ safe transition from the hospital or skilled nursing facility settings to home. They closely collaborate with Hospitalists, acute care interdisciplinary teams, Post-Acute Care and Primary Care teams to drive discharge planning and post-discharge care coordination.
Your primary responsibilities will involve work across the continuum of care: conducting an extensive clinical review of our hospitalized patients, focusing on identifying/resolving care gaps and barriers to discharge, working closely with the interdisciplinary team to create a safe discharge plan, and communicating the plan to patients and providers. The RN Case Manager’s work will support the goals of preventing ER utilization, preventing hospital admissions/readmissions, and ensuring safe transition back to the community with appropriate follow up appointments and services in place.
The role includes but is not limited to the following clinical and administrative tasks:
Job Requirements
· St. Catherine’s of Siena Medical Center
· St. James Rehabilitation and Healthcare Center
· Smithtown Center for Rehab and Nursing Care
· St. Charles Hospital
· Mather Hospital
Performance Requirements
Salary and Benefits