Job Description Travels to non-System facilities. Has knowledge of each facility's discharge planning process to accept and refer patients appropriate for skilled home care services. Under supervision, formulates and implements a Home Care Plan in conjunction with the physician, patient, patient's family and discharge planner. Job Responsibility Responds to referrals in a timely manner and evaluates patients for appropriateness of skilled home care services. Plans for the skilled home care needs of patient in a timely manner to ensure patient's expeditious movement to the appropriate level of care. Implements a comprehensive home care plan based on the in-depth assessment of the patient's needs, including coordination of activities with family, informal supports and other community resources. Maintains working knowledge of third-party reimbursement guidelines and regulation standards. Functions as a home care service resource person. Performs job functions in a fiscally responsible manner consistent with the mission and vision. Assists with orienting new nursing personnel to department policies, procedures and practices. Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions. Job Qualification Graduate from an accredited School of Nursing. Bachelor's Degree in Nursing, preferred. Must be enrolled in an accredited BSN program within two (2) years and obtain a BSN Degree within five (5) years of job entry date. Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. Minimum two (2) years of experience in acute care - med/surg strongly preferred. Experience in community health, hospice, and home care is highly preferred. Experience in Hospice Care, Admissions and/or Referrals is highly preferred. •Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity). The salary range for this position is $75020.00-$126250.00/year. Salary ranges shown on third-party job sites may not accurately reflect ranges provided by Northwell Health. Candidates should check Northwell Health Careers for accurate information and discuss salary/hourly details and our comprehensive benefits with a recruiter, if selected for an interview.