About the Role
Grampians Health's Transition Care Program is seeking a Registered Nurse to join our team in Ballarat. As a Transition Care Program RN Care Coordinator, you will play a vital role in providing care coordination and short-term case management, supporting clients in achieving restorative goals and transitioning to appropriate care.
Key Responsibilities:
* Provide short-term care coordination and support for older adults transitioning between acute/subacute and residential aged care, adhering to TCP guidelines.
* Develop and monitor care plans, ensuring client-centered approaches and collaboration with clients, families, and multidisciplinary teams.
* Ensure compliance with National Safety & Quality Health Service Standards (NSQHS) and Aged Care Quality Standards in all care delivery.
* Coordinate services, crisis planning, and early interventions, liaising with service providers, GPs, and specialists to meet client goals.
* Maintain comprehensive documentation and manage case load, escalating issues as necessary to the TCP Team Leader or Manager.
Skills and Experience Required
* Proven skills in assessment, management, care planning, goal setting, and discharge planning for people with complex medical, aged, and/or psychosocial needs.
* Proven experience in Care Coordination or Case Management.
* Previous experience working in a multi-disciplinary team.
* A good understanding of aged care services.
About This Opportunity
This role offers the opportunity to work in a dynamic healthcare environment, providing high-quality care to rural and regional communities.
You will have the chance to develop your skills and expertise, working collaboratively with a diverse team of healthcare professionals.