Under the direction of the Supportive Care Manager, the Care Transition Coordinator - Supportive Care is responsible for individual patient/family assessment, facilitating patient care, performing patient and family education in conjunction with the Supportive Care medical providers. Assessment will include complex medical, emotional, social, spiritual and financial needs and assisting families and healthcare team to create a comprehensive care plan based on family goals. Regularly communicates with Social Services to help facilitate to both community-based and Providence resources. This position is the hub of multiple lines of communication between the patient, referring physician, palliative care physician and both inpatient/outpatient support services providers. This position is also responsible for assessing and facilitating appropriate treatment per orders for patients who are at end of life on Comfort Care. The position encompasses the roles of nursing assessment, liaison abil...