Care Coordinator - Transition Care Program (TCP)
Core
Provide short-term care coordination, allied health, and support services to older people following hospital admission in bed-based or home-based settings.
Role type
Registered Nurse or Allied Health Professional (Care Coordinator)
Builds
Collaborative care plans and monitoring for older adults transitioning from hospital to community or aged care.
Domain
Healthcare / Aged Care / Transition Care
Deliverable
physical/clinical work
Required skills
Clinical knowledge, problem solving, care planning, multi-disciplinary collaboration, stakeholder liaison
Preferred skills
Community setting experience, hospital environment experience, aged care setting experience
Technologies
AHPRA registration system
Responsibilities
Coordinate admissions, care planning, care monitoring, and exit/discharge planning; Liaise with hospital teams, GPs, Geriatricians, and specialists; Ensure multi-disciplinary approach to client care.
Seniority
Mid-level, clinical professional