Under the direction of the CMO, leads the Transition of Care team to help direct the navigation of patients and families through the continuum of care. Works collaboratively with providers to coordinate continuing care as appropriate. The Director will develop and maintain an advocacy relationship with the patient, family, physicians, and other providers to remove barriers to timely and effective care. Will continually provide information, support, encouragement and assistance in overcoming barriers to patients receiving care throughout the continuum.

Coordinates and directs the activities of Transition of Care.
Supervises and manages effective workflow processes.
Participates in Performance Improvement activities.
Ensures communication with the patient and family through the patient's in patient episode of care.
Builds and maintains relationships with community partners throughout all post-acute service lines.
Serves as a qualified and positive resource to all staff and team members.
Demonstrates program and service line advocacy at all times and displays a positive image to the community by being visible and participating in community agencies and activities.
Protects the confidentiality of patient data.
Maintains confidentiality of all patient information and adheres to departmental and hospital information privacy and security policies.
Provides education to Directors/Team Leaders within the Health System regarding barriers to discharge from the hospital.
Other duties as assigned.

Alabama or MSL LPN, RN or LBSW required

Case Management or Utilization review experience preferred

LBSW, Alabama or MSL license as a Licensed Practical Nurse/Registered Nurse