Transition Specialist Hospice Rn Ot Pt or Slp

CarePartners of Connecticut is seeking a compassionate and clinically skilled Transition Specialist (Hospice RN, OT, PT, or SLP) to support patients and families as they move into hospice and palliative care services. In this role, you will serve as a key clinical liaison between hospitals, skilled nursing facilities, primary care practices, and hospice providers to ensure that patients experience a smooth, well‑coordinated transition of care at the end of life. Drawing on your background as a registered nurse, occupational therapist, physical therapist, or speech‑language pathologist, you will assess clinical needs, educate patients and caregivers about hospice options and benefits, and help create individualized transition plans that align with each patient’s goals, values, and cultural preferences. Working within CarePartners’ collaborative network, you will partner closely with case managers, social workers, hospice medical directors, and community providers to identify eligible patients, coordinate timely referrals, and reduce avoidable hospital readmissions. You will conduct comprehensive assessments in the hospital or home setting, review medical history and prognosis, and communicate clinical findings and recommendations clearly to both families and providers. You will guide families through consent and enrollment processes, clarify insurance coverage, and ensure that equipment, medications, and in‑home support services are in place before and after discharge. The Transition Specialist will also support quality and performance improvement activities by monitoring transition outcomes, documenting accurately in electronic medical records, and escalating complex clinical or psychosocial issues to the interdisciplinary team. You will serve as an educator and advocate, offering training and in‑services to provider offices and care teams on hospice eligibility, symptom management basics, and best practices in end‑of‑life communication. Consistent with CarePartners’ mission and culture, you will model compassion, cultural humility, and respect for patient autonomy, while working collaboratively to improve community health and access to coordinated, patient‑centered care. This position is ideal for a hospice‑experienced RN, OT, PT, or SLP who is comfortable in the field, enjoys both direct patient contact and provider‑facing work, and is motivated to improve the overall experience of patients and families during one of the most sensitive phases of care. The role typically requires regular travel within the local community to hospitals, skilled nursing facilities, and patient homes, as well as strong organizational and communication skills to manage multiple transitions concurrently. CarePartners offers a supportive, team‑oriented environment with opportunities to shape how hospice transitions are delivered across our Connecticut provider network.