NP PCU Full-time
Trio Health Partners

Transitional Care Management Nurse Practitioner Remote

Trio Health Partners IL, US

Nurse Practitioner (NP) — Transitional Care Management (TCM) Provider (Remote)

Position Overview
We are seeking a licensed Nurse Practitioner (NP) to provide Transitional Care Management (TCM) services for patients discharged from our partner skilled nursing facilities. This role focuses exclusively on conducting post-discharge patient visits via telehealth (video or phone) to support continuity of care, improve outcomes, and reduce readmissions.

Key Responsibilities

  • Conduct Transitional Care Management (TCM) visits for patients following discharge from skilled nursing facilities

  • Perform patient encounters via video or phone (fully remote role)

  • Review and synthesize clinical data from hospital and post-acute care stays

  • Assess patient status, address clinical needs, and provide appropriate care guidance

  • Document visits accurately and efficiently within the designated platform

  • Communicate clearly with patients, caregivers, and care teams

  • Manage and maintain a full patient schedule based on availability

  • Navigate clinical situations appropriately and escalate when necessary

  • Utilize technology platforms to deliver care and manage workflows

  • Deliver high-quality patient care exclusively in a virtual environment

Visit Structure & Work Environment

  • Visits typically last up to 20 minutes per patient

  • Flexible patient volume based on provider schedule and availability

  • 100% remote — no field work, bedside care, or in-person clinical responsibilities

  • Fully technology-enabled care delivery model

Required Qualifications

  • Active and unrestricted Nurse Practitioner license

  • Experience reviewing and synthesizing clinical information from hospital and post-acute care settings

  • Strong clinical judgment and patient care skills

  • Excellent communication and patient engagement abilities

  • Highly tech-savvy and comfortable using digital health platforms

  • Ability to manage schedules independently and maintain productivity

  • Comfortable working exclusively in a remote, telehealth-based environment

Preferred Qualifications (Optional)

  • Prior experience with Transitional Care Management (TCM) services

  • Experience in skilled nursing, post-acute care, or care coordination

  • Telehealth or virtual care delivery experience

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