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Transitional Care Nurse Jobs (NOW HIRING)

Temple University Health System

In collaboration with the patient/family, physicians, and the interdisciplinary team, the Transitional Care Nurse Navigator facilitates the patient's progress through the acute episode of care in an ...

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$56

How much do transitional care nurse jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for transitional care nurse in the United States is $38.15, according to ZipRecruiter salary data. Most workers in this role earn between $28.37 and $36.06 per hour, depending on experience, location, and employer.

What is a transitional care nurse?

A Transitional Care Nurse is a registered nurse who specializes in helping patients transition between different levels of care, such as from hospital to home or to a rehabilitation facility. Their primary goal is to ensure continuity of care, reduce hospital readmissions, and promote positive health outcomes. They coordinate with healthcare teams, provide patient education, and support patients and their families throughout the transition process. Transitional Care Nurses play a vital role in managing medication, follow-up appointments, and addressing any concerns patients may have after discharge.

What does a transitional care nurse do?

A transitional care nurse oversees the care of a patient as they move from one health care facility, such as a hospital or nursing home, to another facility or their home. The transitional care nurse ensures the relocation is as smooth as possible and helps the patient remain comfortable during the change. In this role, your job duties include creating a transitional care plan with the patient's physician and family members to determine when and how the move should be made. Once the patient is established in the new facility or back at home, you visit them regularly to assess their health and recovery. The transitional care model (TCM) of health care aims to reduce disruption in care, and thus lower the chances of patients relapsing and having to return to the hospital.

What are the key skills and qualifications needed to thrive as a transitional care nurse, and why are they important?

To thrive as a Transitional Care Nurse, you need expertise in patient assessment, care coordination, and discharge planning, typically backed by an RN license and experience in acute or post-acute care settings. Familiarity with care management software, electronic health records (EHRs), and sometimes case management certifications like CCM are common requirements. Strong communication, problem-solving, and organizational skills help build trust with patients and collaborate across multidisciplinary teams. These skills are crucial for ensuring seamless transitions between care settings, reducing hospital readmissions, and improving patient outcomes.

What are some common challenges faced by a transitional care nurse when coordinating patient care across different healthcare settings?

Transitional Care Nurses often encounter challenges such as fragmented communication between hospitals, primary care providers, and community services, which can impact the continuity of patient care. They must ensure that patients and families understand complex discharge instructions while also managing follow-up appointments and medication changes. Balancing a diverse caseload and addressing social determinants of health, such as transportation or home support, requires strong organizational and advocacy skills. Collaboration with multidisciplinary teams is essential to overcome these obstacles and promote positive patient outcomes.

What is the difference between Transitional Care Nurse vs Home Health Nurse?

AspectTransitional Care NurseHome Health Nurse
CredentialsRN license, possibly certification in care managementRN license, often certification in home health or hospice
Work EnvironmentHospitals, clinics, transitional care settingsPatients' homes, community settings
Employer & IndustryHospitals, healthcare systems, transitional care agenciesHome health agencies, hospice providers

Transitional Care Nurses and Home Health Nurses both provide patient care, but Transitional Care Nurses focus on coordinating care during patient transitions from hospital to home or other settings, often working in healthcare facilities. Home Health Nurses primarily deliver care directly in patients' homes, managing ongoing health needs. While their roles overlap in patient education and care management, their work environments and specific responsibilities differ.

What is the best career for transitional care nurses to transition to?

Transitional care nurses often transition into roles such as case managers, care coordinators, or outpatient nurse practitioners, leveraging their skills in patient education, discharge planning, and care management. Additional certifications like case management certification or advanced practice licenses can facilitate these transitions and expand career opportunities.
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Transitional Care Nurse jobs near you
Infographic showing various Transitional Care Nurse job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 70% Full Time, 21% Part Time, and 7% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $79,354 per year, or $38.2 per hour.

Transitional Care Nurse - Home Health RN

Saint Luke's Health System

Kansas City, MO • On-site

Full-time

Re-posted 12 days ago

Saint Luke's Health System (Kansas City) rating

7.1

Company rating: 7.1 out of 10

Based on 110 frontline employees who took The Breakroom Quiz

379th of 898 rated healthcare providers

Job description

Job Description
Saint Luke's Home Care & Hospice is seeking a Transitional Care Nurse to join our team!!
  • FT; M-F
  • Flexible scheduling
  • one weekend every 1-2 months for telemonitoring
  • Clean driving record required
  • Field position driving/covering territories in Kansas and Missouri
  • BSN required
  • RN in MO & KS required
  • 2 years of experience required
  • Coverage area is Kansas City Metro, may assist in rural areas within Leavenworth, Jackson, Clay, and Platte counties
  • Experience in Home Health, Hospice, Case Management preferred

The Transitional Care Nurse TCN , under the direction of the Director of Operations, serves as a key point of contact for care coordination and transition management for Saint Luke's Home Care and Hospice patients who move from the acute hospital and facility to the home settings and within levels of care when already home. The TCN will support patient self management, advocacy and oversee education and engagement, coaching and counseling of patient and family. Cross setting communication, teamwork and collaboration will be required for patient centered care planning and the nursing process will be utilized for ongoing assessment and outcome setting for each population managed
Why Saint Luke's?
  • We believe in work/life balance.
  • We are dedicated to innovation and always looking for ways to improve.
  • We believe in creating a collaborative environment where all voices are heard.
  • We are here for you and will support you in achieving your goals.

#LI-CK2
Job Requirements
Applicable Experience:
2 years
Basic Life Support - American Heart Association or Red Cross, Registered Nurse - Various
Bachelor's Degree
Job Details
Full Time
Day (United States of America)

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