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Transitional Care Nurse Jobs (NOW HIRING)

Your Health

Transitional Care Professional

Pooler, GA · On-site

The Transitional Care Professional position plays a crucial role in facilitating a smooth transition for patients from hospitals, rehabilitation centers and skilled nursing facilities to their homes ...

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How much do transitional care nurse jobs pay per hour?

As of Aug 8, 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 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 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 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 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 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.
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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, 69% Full Time, 22% Part Time, and 7% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $79,354 per year, or $38.2 per hour.

Transitional Care Professional

Your Health Inc

Marietta, GA • On-site

Other

Medical, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

We are seeking a qualified candidate to act as the clinical liaison for our patients throughout the Marietta area. The Transitional Care Professional position plays a crucial role in facilitating a smooth transition for patients from hospitals, rehabilitation centers and skilled nursing facilities to their homes by providing comprehensive care coordination and support. The Transitional Care Professional plays a vital role in enhancing the patient experience and reducing hospital readmissions
Transitional Care Professional perform visits in homes and facilities (ALF and ILF's) in their designated service area. You must have reliable transportation as travel is required daily. This is a full time, salary-based working 8-hr shifts Monday-Friday (8am-5pm)
The following service area(s) are currently available:
  • Marietta area
About
We are a leading physician group serving South Carolina and Georgia, dedicated to delivering quality healthcare directly to patients in care facilities, homes, clinics, and virtual visits. Our services include comprehensive primary care, specialty services, and pharmacy support, tailored to meet diverse patient needs. Committed to excellence and innovation, our team collaborates closely with facilities and families to ensure accessible, coordinated, and compassionate care.
Why Choose a Career at Your Health?
Providing high quality care for our patients is the center of what we do, and we provide the same care for our employees. Here are some of the benefits that are available to our employees.
  • Competitive Compensation Package with Bonus Opportunities
  • Employer Matched 401K
  • Free Visit & Prescriptive Services with HDHP Insurance Plan
  • Employer Matched HSA
  • Generous PTO Package
  • Career Development & Growth Opportunities
  • Vehicle allowance
What Are We Looking For?
Your Health is currently looking for a Transitional Care Professional to join our growing primary care family. A successful Transitional Care Professional will be able to perform these essential duties and responsibilities. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions.
The following is a list of essential functions, which may be subject to change at any time and without
notice. Management may assign new duties, reassign existing duties, and/or eliminate function(s)
Area of Responsibility:
  • Visit the Company's referrals and established patients within assigned facilities.
  • Establish trust and rapport with patients to assist them in making informed decisions regarding their health during their stay in the facility.
  • Provide guidance and feedback to patients based on recommendations from the care team regarding their care.
  • Ensure a seamless transition for patients returning home by arranging the necessary services, such as home health, outpatient rehab, and follow-up care with the Company's providers and support staff.
  • Ensure all essential visits are scheduled including those with the Company's primary care provider, virtual provider, specialists, pharmacists, social workers, etc.
  • Facilitate effective communication between healthcare professionals involved in the patient's care.
  • Ensure patient and family adherence to the plan of care.
  • Interact with patients via phone, email, patient portal, telephone, AthenaText, in person, etc. to gather necessary information.
  • Provide exceptional customer service to patients, exhibiting a compassionate and empathetic attitude and a patient-centered approach to care. Address patient concerns, inquires, and complaints professionally and promptly, striving to meet patient needs and ensure their satisfaction.
  • Perform general administrative tasks and support other staff as needed.
  • Utilize the company's software systems to enhance patient care and staff efficiency.
  • Must be available during normal work hours (unless previously approved by direct supervisor).
  • Utilize the company's software systems and update information as required.
  • Participate in coaching calls.
  • Perform other duties as requested or required, in the sole discretion of the Company.
Qualifications:
  • Certified Medical Assistant, Paramedic, or Licensed Nurse preferred. Certifications or licenses must be in good standing.
  • Previous experience in public health or home health preferred.
  • A minimum of three (3) years clinical experience preferred.
  • Demonstrated ability to supervise and direct professional and administrative personnel.
  • Ability to read and communicate effectively.
  • Strong written and verbal skills.
  • Strong organizational and time management skills, with the ability to multitask and prioritize responsibilities effectively.
  • Basic computer knowledge.
  • Ability to manage and demonstrate effective leadership skills.
  • Should demonstrate good interpersonal and communication skills under all conditions and circumstances.
  • Ability to foster a cooperative work environment.
  • Team player with ability to manage multiple responsibilities and demonstrate sound judgment.
  • Must be able to work flexible hours and travel between offices, facilities, etc. Must be a licensed driver with an automobile that is insured in accordance with state and/or organizational requirements and is in good working order.

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