**Description**



Plans and coordinates activities related to transition planning. Develops and implements a plan of care designed to meet the patient's post hospitalization needs while ensuring continuity of care. Responsible for the collaboration with medical staff, patient, family, community agencies, or facilities involved in patient's care, and the health care team by assessing, facilitating, planning and advocating for health needs on an individual basis resulting in quality, cost-effective outcomes.



Will not provide services to patients with complex social, mental, and cognitive impairments per the risk stratification system. Majority of work will be providing services to patients who are transferring to Long-term care, skilled nursing facilities, assisted living, adult family homes, etcetera.



Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Regional Medical Center Everett and thr...