Medical - RN Hospital Liaison - Integrated

Marana Health is seeking a RN Hospital Liaison - Integrated to join the Medical team at the Marana Main Health Center, located in the heart of Marana, AZ.

The RN Hospital Liaison serves as the primary clinical coordination link between hospitals, behavioral health facilities, emergency departments, specialty facilities, and outpatient care teams to support safe, timely, and effective transitions of care. The RN Hospital Liaison collaborates closely with hospital-based case managers, behavioral health (BH) Care Coordinators, providers, care teams, and community resources to coordinate discharge planning, reduce re-admissions, improve continuity of care, and address medical and behavioral health needs for patients transitioning across care settings. This role supports integrated, patient-centered care through proactive communication, follow-up, care coordination, and collaboration with interdisciplinary teams across medical and behavioral health services.

Marana Health is a Federally Qualified Community Health Center (FQHC), with 11 sites in Tucson and Pima County. Our mission is to improve our community by providing exceptional, whole-person healthcare.

The following qualifications are required:

• Associate degree in Nursing
• Valid Arizona State License as a Rgistered Nurse
• 2 years' of nursing experience
• Basic Life Support (BLS) Certification
• Fingerprint Clearance Card through the Arizona Department of Public Safety
• Current Arizona driver's license with clean driving record and proof of current vehicle insurance (39-month MVR will be run by MH)

The following qualifications are preferred:

• Bachelor's degree in Nursing
• Experience in care management, hospital discharge planning, population health, or disease management
• Experience working with behavioral health populations, psychiatric facilities, or integrated care models
• FQHC or community health experience
• Bilingual (English/Spanish)

Equivalent combination of education and experience may be considered if applicable and must be directly related to the functions and body of knowledge required to successfully perform the job.

This position has the following supervisory responsibilities:

Does not dierct or supervise others

The ideal candidate will also possess the following knowledge, skills, and abilities:

• Knowledge of care transitions, discharge planning, and population health principles
• Competent in managing all age groups including neonates, infants, children, adolescents, adults, and geriatric patients.
• Understanding of behavioral health systems, crisis intervention, and community resources.
• Strong clinical assessment and critical thinking skills
• Ability to manage comlex patient cases across multiple care settings
• Excellent communication, collaboration, and relationship-building skills
• Ability to work effectively with interdisciplinary medical and behavioral health teams
• Proficiency with electronic health records and care management platforms
• Strong orgnaiztional skills with ability to prioritize multiple tasks and deadlines
• Demonstrate cultural competence and effective communication and interpersonal skills with diverse patient populations
• Ability to work independently while maintaining strong team collaboration

Duties and Responsibilities:

• Serve as the primary point of contact between hospitals, behavioral health facilities, emergency departments, and outpatient care teams.
• Collaborate with BH Care Coordinators, inpatient case managers, social workers, and discharge planners to coordinate safe patient transitions.
• Offer assistance to those members who do not have a primary care provider to select a PCP for care coordinatin and imporved outcomes.
• Facilitate communcation between primary care specialty care, behavioral health, care management, and community-based services.
• Support patients with complex medical, behavioral health, and social needs through care coordinatin and resouce linkage.
• Conduct telephonic and/or in-person patient outreach following hospital or behavioral health discharge.
• Identify barriers to care, including transportation, housing instability, medication access, insurance, and social determinants of health.
• Collaborate with behavioral health teams to support patients experiencing mental health crises, substance use disorders, or psychiatric hospitalization.
• Complete transition of care management during post hospital outreach.
• Educate patients and families regarding discharge instructions, medications, treatment plans, and available community resources.
• Monitor and track transition of care metrics, readmissions, and emergency department utilization.
• Maintain compliance with HIPAA, regulatory requirements, organizational policies, and nursing standards of practice.
• Assist with development and maintenance of collaborative relationships with hospitals, behavioral health facilities, and community partners.
• Perform other duties as assigned.

Benefits:

Marana Health's vision is to be the premier provider and employer in community health. To support our mission and vision in our community, Marana Health believes health and well-being must start at home. Therefore, employees have many opportunities to care for our own health and wellness with benefits such as:

Medical, Dental, and Vision

403(b) with employer contribution

Short-term disability and other benefits

Paid time off including 11 holidays plus vacation and sick leave accrual

Paid bereavement, jury duty, and community service time

Education reimbursement ($3,000 per year for full-time)

Marana Health is committed to providing equal employment opportunities to all individuals, including those with disabilities and pregnancy-related conditions. If you require a reasonable accommodation to apply for a position or to participate in the interview process under the Americans with Disabilities Act (ADA) or the Pregnant Workers Fairness Act (PWFA), please contact our Human Resources Department at 520-682-4111.

Marana Health will recruit, hire, train, and promote persons in all job titles without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.