The Transition Support Nurse is a Registered Nurse within the Home Care department who focuses on supporting patients and families during critical transitions in the hospice journey. This includes providing increased clinical presence for patients who are actively transitioning toward end of life and completing timely initial nursing assessments for patients already admitted to hospice when additional assessment support is needed.
This role operates flexibly across field and office settings to ensure high-quality patient care, timely and accurate documentation, and strong coordination across the interdisciplinary team. The Transition Support Nurse serves as a clinical stabilizer for the system, helping close gaps in care delivery, improve responsiveness, and support operational performance.
Graduate of an accredited school of Nursing, BSN preferred
Active RN License in the state of Georgia
CPR Certification required
Valid driver’s license, automobile insurance, and reliable transportation required.
Hospice or homecare experience
Competencies, Preferred Knowledge, Skills, and Abilities
Strong clinical assessment and symptom management skills
Ability to work independently and adapt to rapidly changing patient needs
Strong documentation and time management skills
Comfort with EMR systems and technology
Experience with end-of-life care and hospice transitions
Experience working across field and office-based roles
Familiarity with AI or data-informed clinical workflows
Physical Demands and Work Environment
This position requires sustained visual concentration, including reading documents, using a computer, and reviewing patient charts for extended role involves regular verbal and written communication, problem solving, and the ability to maintain a professional demeanor in a healthcare setting. The position may require requires the mobility to ambulate or lift a patient with or without the assistance of devices in excess of 75 pounds using proper body mechanics. The work environment presents a moderate risk of exposure to infectious diseases and requires compliance with established safety, infection control, and personal protective equipment (PPE) protocols. The position may require to provide care in what has been determined by local authorities as a high-risk crime area and unsafe situations (potential or actual).
Position Type and Expected Hours of Work
This is a full-time, non-exempt position working a 30-40 hour week, rotating days, evenings, or weekends, with occasional requests to work additional days/hours/holidays as needed. The position is required to take back-up on call. Travel
Must be able to travel as required which includes between patient homes, Hospice Savannah entities, and other designated locations using a personal vehicle.
