RN Clinical Transitions Specialist – Inpatient Case Management

Carle Health

. Oversee, coordinate, and manage functional and financial outcomes during acute hospitalization .

Posted 9/25/2026full-timePeoria • Illinois • United StatesMid-LevelSenior💰 $36 - $58 per hourWebsite

About the role

Key responsibilities & impact

Oversee, coordinate, and manage functional and financial outcomes during acute hospitalization
Perform proactive initial assessments, ongoing evaluations, and discharge planning
Facilitate safe and timely transitions from inpatient care to appropriate post-hospital care
Liaise with patients, families, physicians, consultants, and internal and external referrals to determine the next level of care and manage length of stay
Document plans of care and utilization issues in case management/utilization review software and multidisciplinary care documents
Evaluate care-plan effectiveness and collaborate with physicians to support patient outcomes and reduce readmission risk
Investigate coverage for post-hospital needs and present options to patients, families, and providers
Initiate pre-hospital, in-hospital, and post-hospital interventions
Participate in multidisciplinary rounds and make timely referrals to healthcare team members
Assess, plan, arrange services, monitor, provide support and education to clients, caregivers, and families
Track avoidable inpatient days and perform readmission assessments
Assess post-discharge needs within 24–48 hours of admission and throughout the stay
Arrange durable medical equipment, home care, outpatient infusion, hospice, extended care facility placement, and transportation
Deliver or delegate regulatory letters for Medicare and observation patients
Arrange and attend patient/family care conferences
Conduct case review presentations for peers on challenging cases and scope-of-practice issues

Requirements

What you’ll need

Licensed Registered Professional Nurse (RN) with the Illinois Department of Financial and Professional Regulation (IDFPR)
Bachelor's Degree
Ability to work 40 hours per week, Monday–Friday, 8 a.m.–5 p.m.
Availability for department rotation on weekends
Availability for department rotation on holidays

Benefits

Comp & perks

Comprehensive benefits package
Opportunities for growth and life-long careers