**JOB SUMMARY** The Program Outcome Manager RN facilitates patient continuity of care with the multidisciplinary team in an effort to prepare the family for discharge of the patient. This position will collaborate with physicians, nursing staff and other members of the healthcare team to advocate for the family, coordinate care plans of the multidisciplinary team, educate both the family and staff, and improve quality care and family-centered care within the service line. **ESSENTIAL FUNCTIONS OF THE ROLE** Collaborate with the health care providers to improve continuity of care, family participation in care and education of parent and family members. Acts as a liaison between departments in the service line and multidisciplinary areas as well as the health care providers. Serves as the contact person for families in the service line throughout the length of stay in the service line. Meets with patient and family regularly to discuss the continuum of care issues including education, identification of resources and follow-up care. Completes discharge phone calls on all patients discharges to assure family understanding of discharge orders and follow up appointments. Identifies and acts upon opportunities for intervention when there is a lack of established treatment plan with specific goals, over or underutilization of services, premature or delayed discharge, ineffective treatment plan, or medical, psychological and functional needs. Participates and coordinates case conferences for staff and providers to maintain and improve quality care. Participates in and identifies opportunities for continuous quality improvement projects in order to better serve the patient, family and healthcare system to improve the quality of service provided.Collects/analyzes outcome measures in order to improve practices around discharge preparation for the family. Identifies and meets educational needs of staff involving family centered care and discharge preparation of the family. Collaborates with the leadership team to assure successful implementation of projects and education. **KEY SUCCESS FACTORS** Bachelor's degree in nursing, healthcare administration or related field. Maintains knowledge of current evidence based care in the service line. Excellent verbal and written communication skills required. Ability to monitor, assess and record patient progress against a plan of care. Ability to facilitate patient access to community resources. Ability to work collaboratively with both internal and external medical staff, external partners and organizations. Ability to assess, adapt and calmly respond to changing and crisis environments. Ability to maintain confidentiality with all aspects of patient information in accordance with all applicable policies and regulations. **BENEFITS** Our competitive benefits package includes the following - Immediate eligibility for health and welfare benefits - 401(k) savings plan with dollar-for-dollar match up to 5% - Tuition Reimbursement - PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level + Possession of Bachelor's degree in Nursing + A minimum of (3) three years' of relevant professional experience. + Registration as Nurse (RN) **PREFERRED QUALIFICATIONS: Cardiovascular and ERAS experience** As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.