Transitions of Care LPN

• Hours Per Week: 20
• Shift Start and End Times: Monday through Friday 8:30-12:30pm

UConn Health Community Network Medical Group, Inc. seeks a 20‑hour per week Transitions of Care LPN in the Administration – Medical Group department. The nurse will review discharge documentation in the EMR, contact patients after hospital or skilled‑nursing‑facility stays, clarify care plans, and ensure information needed for Transitional Care Management (TCM) appointments is complete and accurate.

Responsibilities

• Review daily discharge summaries and EMR documentation for Internal Medicine patients.
• Conduct outreach phone calls within 48 hours of discharge.
• Clarify hospital events, medication changes, and follow‑up instructions with patients and caregivers.
• Document call outcomes and any identified gaps in care in the EMR.
• Coordinate with providers to schedule TCM appointments as needed.
• Educate patients on post‑discharge self‑management and red‑flag symptoms.
• Communicate pertinent information to the care team to facilitate continuity of care.
• Track and report key metrics such as call completion rates and TCM billing eligibility.
• Maintain compliance with HIPAA and UConn Health policies during all communications.
• Participate in quality improvement initiatives related to transitional care.

Qualifications

• Active Licensed Practical Nurse (LPN) license in Connecticut.
• Minimum 1 year of clinical nursing experience, preferably in acute care, SNF, or case management.
• Strong verbal and written communication skills.
• Proficiency with electronic medical records (Epic preferred).
• Ability to work independently and manage a 20‑hour weekly schedule.
• Knowledge of Transitional Care Management (TCM) billing requirements.
• Excellent organizational and time‑management abilities.
• Demonstrated empathy and patient‑centered approach.
• Basic computer skills (Microsoft Office, email, phone systems).
• Commitment to maintaining confidentiality and adhering to regulatory standards.

About Us

The UConn Health Community Network is a not-for-profit organization created to extend UConn Health’s mission by partnering with community hospitals and connecting them to its clinical expertise, academic strength, and operational resources.

Today, the network is a thriving community‑based system of care serving more than 280,000 residents across the region. It employs over 2,000 professionals and supports a medical staff of roughly 700 clinicians.

At its core is Waterbury Hospital, a 347‑bed community teaching hospital affiliated with the University of Connecticut School of Medicine. Alongside Connecticut Children’s, the UConn Health Community Network Medical Group, Access Rehab Centers, and its role as a leading partner in the Harold Leever Cancer Center, the network has been shaping the region’s healthcare landscape for more than 130 years.

And Waterbury Hospital is only the beginning — the network is designed for continued growth, deeper partnerships, and broader regional impact.