Job Description​

The Opportunity:

Saint Luke’s Home Care & Hospice is seeking a full-time Transitional Care Home Health Registered Nurse to join our team. The Transitional Care Nurse TCN, under the direction of the Director of Community Services, serves as a key point of contact for care coordination and transitional management for SLHS Home Care and Hospice patients moving across the continuum of care. 

The TCN will also serve as a key point of contact for SLHS patients that are enrolled in the Primary Care at Home program and other collaborative efforts with the Population Health Management Team. Will facilitate virtual visits with their healthcare providers periodically, perform visits in the home for both SLHS Home Care and Hospice patients as well as Primary Care at Home patients, providing assessment, evaluation, education, coaching and counseling of patient and families.  The TCN will also study the Care Coordination Transitional Care Management curriculum and pass an exam within the first year of employment in this position.  The core curriculum consists of:  advocacy, education and engagement of individuals and families, coaching and counseling of individuals and families, person-centered care planning, support for self-management, nursing process, teamwork and collaboration, cross setting communications and care transitions, population health management, informatics to support nursing practice, telehealth nursing practice.

The Work:

As a TCN, you will perform the following functions:

• Disease management
• Monitoring of telehealth patients as appropriate.
• Utilize the nursing process throughout the provision of patient/family care.
• Collaborate with the medical staff and the other disciplines to provide and enhance patient care
• Adhere to all nursing policies and standards, and proactively strive to maintain and improve quality outcomes

 Why Saint Luke’s Home Care and Hospice?

• Our leadership supports nurse engagement and allows their voices to be heard. 
• We value our nurses’ knowledge, experience, and expertise to improve patient outcomes and quality care. 
• The opportunity to balance all facets of your life through flexible and creative scheduling that meet your needs as well as your patients.
• Strong nurse governance and we encourage all of our RNs to participate 
• Various CEU, Continuing Education, Leadership and other career training available
• Career Advancement Program dedicated to RNs.
• Saint Luke’s offers competitive salaries and benefits packages to all of their employees, click here to find out more.

Job Requirements

Applicable Experience:

Job Details

The best place to get care. The best place to give care. Saint Luke’s 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke’s means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter.

Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.

Effective November 1st, 2021, full COVID-19 vaccination is a condition of employment for all Saint Luke’s Health System employees unless a medical or religious exemption is approved.