Registered Nurse Transitions-of-Care Coordinator
Chest Medicine Associates
Registered Nurse Transitions-of-Care Coordinator
South Portland, Maine
Chest Medicine Associates is seeking a full-time Registered Nurse to serve as the RN Transitions-of-Care Coordinator-Pulmonary Medicine to serve as a central resource for patients, families, physicians, and hospital teams, ensuring timely follow-up, seamless communication, and coordination of complex pulmonary care.
This is a full-time, Monday–Friday daytime position with no routine evening, weekend, or holiday responsibilities. This position will be grant-supported for two years and may be contingent on renewal of grant funding.
Requirements:
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Registered Nurse with an active, unrestricted Maine license.
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Bachelor of Science in Nursing (BSN).
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Current American Heart Association Basic Life Support (BLS) certification.
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Minimum of two years of clinical nursing experience.
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Strong clinical assessment and telephone triage skills.
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Excellent communication and interpersonal skills.
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Proficiency with electronic health record systems and Microsoft Office applications
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Experience in pulmonary medicine, hospital medicine, case management, care coordination, and/or transitions of care is preferred
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Experience caring for patients with COPD, ILD, asthma, bronchiectasis, or other chronic respiratory diseases is preferred.
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Familiarity with pulmonary rehabilitation, home oxygen therapy, durable medical equipment, and insurance authorization processes is preferred.
Benefits of the Job:
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Hourly pay in the range of $40-46 depending on experience and qualifications.
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Health, Dental, Vision Insurance
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401K with match
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PTO and paid holidays
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Profit sharing
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Paid parental leave
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Tuition reimbursement
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Convenient location in South Portland, Maine
Responsibilities:
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Identify hospitalized pulmonary patients appropriate for transitions-of-care services, with emphasis on COPD and ILD.
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Collaborate with inpatient teams, case management, respiratory therapy, pharmacy, and primary care providers and coordinate timely pulmonary follow-up appointments and diagnostic testing.
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Contact patients within 24–72 hours of discharge to assess recovery, reinforce discharge instructions, and identify barriers to care.
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Perform medication reconciliation and reinforce inhaler technique and medication adherence.
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Assess oxygen, nebulizer, CPAP/BPAP, and other durable medical equipment needs.
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Facilitate referrals to pulmonary rehabilitation, smoking cessation, home health, palliative care, and community resources.
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Monitor for clinical deterioration and collaborate with providers to facilitate intervention.
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Coordinate referrals for EBUS and robotic bronchoscopy.
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Schedule procedures and required pre-procedure testing.
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Ensure required imaging and diagnostic studies are available.
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Track patients from referral through pathology results and treatment planning.
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Coordinate post-procedure follow-up and collaborate with the lung cancer screening program to facilitate timely evaluation of abnormal screening findings.
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Perform pulse oximetry testing, nebulizer treatments, medication administration, and other nursing procedures within scope of practice.