RN, Home Care Liaison

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

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Responsibilities:

• Identifies patient discharge needs and is accountable for patient discharge. Assists in implementing patient care strategies to close gaps in medical care upon discharge. Identifies resources for patient self management planning and discharge. Participates in development of discharge plan with short- and long-range care plan goals for patients.
• Coordinates care of patients. Assumes coordination role at the point of admission and through discharge, with targeted coordination and follow-up. Assists in developing and implementing care plans for medically complex patients. Identifies barriers to a successful discharge plan.
• Interacts effectively with physicians, acute care team, patients, and caregivers. Coordinates use of clinical and ancillary resources within and outside of the health system to achieve treatment goals specified in the patient care plan and facilities discharge.
• Keeps abreast with organizational developments and practices that may impact operations by participating in continuing education courses, professional organizations and seminars, reading current literature, and maintaining professional contacts in the community. Assists with the development of current evidence-based protocols, policies, work flow/flow sheets, guidelines, etc. related to the provision of care within the acute care model. Participates in committees as assigned. Provides coverage for all units as needed for absences and vacancies.
• Other duties as assigned.

• Associate's degree in Nursing and 5 years of professional nursing experience required
• Bachelor's degree in Nursing preferred
• Or equivalent combination of education and experience
• Experience in acute care, community health care management, disease management and working with multidisciplinary teams preferred

• Proficient computer skills required
• Familiarity with electronic medical record required

• RN - Registered Nurse - State Licensure and/or Compact State Licensure in New York State (NYS) upon hire required

The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.