The Hospital-Based Transitional Nurse Liaison (TNL) coordinates safe, timely, and effective transitions of care for patients within the HealthPartners enterprise hospital post-acute care network whose clinical needs may be appropriately managed through skilled home care, home infusion, ambulatory infusion suites, outpatient infusion, or other post-acute services. The TNL evaluates clinical, safety, payer, and service appropriateness; coordinates referrals, resources, education, and required documentation; and ensures the receiving team has the information, medications, supplies, equipment, and communication necessary to begin care successfully.