Work where every moment mattersEvery day almost Hartford HealthCare Colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare network as a Care Transition Nurse LPN Hartford HealthCare at Home the largest provider of homecare services in Connecticut has been fulfilling our mission for more than years Our Person Centered Care Model allows our employees to learn and grow within our organization all while providing integrated support to the patient As part of Hartford HealthCare we leverage cutting edge technology to provide quality care in our clientrsquos home Most importantly our employees are appreciated for the real differences they make in both the lives of their clients and their clientsrsquo familiesResponsible for successfully capturing all appropriate data to ensure a safe transition from all referral sources to HHCAH Facilitates continuous throughput of patients to homecare services from all points of entry by utilizing effective verbal communication reviewing technology that supports patient placement activities and swift clinical decision making Liaison between all points of entry acute care facilities sub acute care facilities long term and assisted living facilities as well as other direct admissions from the community the Clinical Home Care Team clinical leadership and other stakeholders throughout the system Applies nursing knowledge as the foundation for clinical triage placement decisions and communications Supports execution and improvement of scheduling standard work Owns all follow up w Case Mgt partners with Rec Cycle for financial clearance and supports regional dispatchingWorks closely with patients to provide best scheduling options Monitors timeliness and appropriateness of referrals partnering with IntakeInsurance Transition Support and Transitional Care Coordinator to support transition to HHCAH and ensuring appropriate discipline visits Responsible for initial assessment of patient home care qualifications including but not limited to authorization of services identification of physicians appropriate home care assignmentDevelop effective relationships with multiple stakeholders including but not limited to System Case Management teams InsuranceIntake Transition Support and Transitional Care Coordinators to enhance patient transition and assignmentIdentify and assure home care clinical needs are in place prior to patient admission to home care services including but not limited to procedural supplies foley NPWT pleural catheter etc Community MD verification community resource needs and appropriate services orderedIncrease effective patient timeliness to care by identifying barriers in assignment processes and collaborate with clinical management in the resolution of these issues Achieve seamless delivery of services by appropriately involving colleagues physicians nurses and other staff to ensure commitment communication and cross functional linkageParticipates in Performance Improvement activities within the Agency Plays a key role in the quality clinical financial and patient satisfaction outcomesParticipate in daily clinical huddles participates in Lean Daily Management and daily and weekly case conferences with the clinical teams as neededWork where every moment mattersEvery day almost Hartford HealthCare Colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare network as a Care Transition Nurse LPN Hartford HealthCare at Home the largest provider of homecare services in Connecticut has been fulfilling our mission for more than years Our Person Centered Care Model allows our employees to learn and grow within our organization all while providing integrated support to the patient As part of Hartford HealthCare we leverage cutting edge technology to provide quality care in our clientrsquos home Most importantly our employees are appreciated for the real differences they make in both the lives of their clients and their clientsrsquo familiesResponsible for successfully capturing all appropriate data to ensure a safe transition from all referral sources to HHCAH Facilitates continuous throughput of patients to homecare services from all points of entry by utilizing effective verbal communication reviewing technology that supports patient placement activities and swift clinical decision making Liaison between all points of entry acute care facilities sub acute care facilities long term and assisted living facilities as well as other direct admissions from the community the Clinical Home Care Team clinical leadership and other stakeholders throughout the system Applies nursing knowledge as the foundation for clinical triage placement decisions and communications Supports execution and improvement of scheduling standard work Owns all follow up w Case Mgt partners with Rec Cycle for financial clearance and supports regional dispatchingWorks closely with patients to provide best scheduling options Monitors timeliness and appropriateness of referrals partnering with IntakeInsurance Transition Support and Transitional Care Coordinator to support transition to HHCAH and ensuring appropriate discipline visits Responsible for initial assessment of patient home care qualifications including but not limited to authorization of services identification of physicians appropriate home care assignmentDevelop effective relationships with multiple stakeholders including but not limited to System Case Management teams InsuranceIntake Transition Support and Transitional Care Coordinators to enhance patient transition and assignmentIdentify and assure home care clinical needs are in place prior to patient admission to home care services including but not limited to procedural supplies foley NPWT pleural catheter etc Community MD verification community resource needs and appropriate services orderedIncrease effective patient timeliness to care by identifying barriers in assignment processes and collaborate with clinical management in the resolution of these issues Achieve seamless delivery of services by appropriately involving colleagues physicians nurses and other staff to ensure commitment communication and cross functional linkageParticipates in Performance Improvement activities within the Agency Plays a key role in the quality clinical financial and patient satisfaction outcomesParticipate in daily clinical huddles participates in Lean Daily Management and daily and weekly case conferences with the clinical teams as neededEducationLPNAccording to state licensure regulationsExperienceMinimum of years home care case management experience with strong knowledge base in navigating medical comorbiditiesLicensure Certification RegistrationLPN According to state licensure regulationsKnowledge Skills and Ability RequirementsExperience with word processing Office Suite and Epic preferredDemonstrated ability to support a highly fluid dynamic operational environmentDemonstrated ability to manage multiple priorities and identify clinical critical patient needsExcellent prioritization and communication skillsDemonstrated excellence in critical thinking communications and conflict resolution skillsDemonstrated ability to implement support and effectively monitor change requiredAbility to collaborate with all layers of the managementadministrativeclinical teams within Hartford HealthCare and the communityHartford Healthcare at Home offers a team oriented structure a comprehensive continuing education program and an excellent benefits packageWe believe in high standardsThese standards allow us to bring out the very best in our clients and our staffWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this is your momentEducationLPNAccording to state licensure regulationsExperienceMinimum of years home care case management experience with strong knowledge base in navigating medical comorbiditiesLicensure Certification RegistrationLPN According to state licensure regulationsKnowledge Skills and Ability RequirementsExperience with word processing Office Suite and Epic preferredDemonstrated ability to support a highly fluid dynamic operational environmentDemonstrated ability to manage multiple priorities and identify clinical critical patient needsExcellent prioritization and communication skillsDemonstrated excellence in critical thinking communications and conflict resolution skillsDemonstrated ability to implement support and effectively monitor change requiredAbility to collaborate with all layers of the managementadministrativeclinical teams within Hartford HealthCare and the communityHartford Healthcare at Home offers a team oriented structure a comprehensive continuing education program and an excellent benefits packageWe believe in high standardsThese standards allow us to bring out the very best in our clients and our staffWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this is your moment