Nurse-RN CTTP (21808)
Northern Rivers Family of Services
Date: 6 hours ago
City: Schenectady, NY
Contract type: Full time

Description
As a Registered Nurse (RN) you will be part of the interdisciplinary Critical Time Transition Program (CTTP) team. You will provide clinical support and care coordination for youth with mental health needs, and their caregivers, when transitioning from hospitalization/hospital stabilization to home and community-based care. You will ensure continuity of care, promote physical and emotional wellness, and help prevent re-hospitalization by delivering health education, and medication support to both youth and their caregivers. You will report to the Director of Hospital to Home and you will work onsite and in the community.
Responsibilities
At Northern Rivers Family of Services, we work together to make a difference in our client's lives. Northern Rivers empowers children, adults, and families to change their lives and build stronger communities.
Northern Rivers Family of Services is an Equal Opportunity Employer. We hire great people from a variety of backgrounds, not because it is the right thing to do, but because it makes us stronger! All applicants will be considered for employment without attention to race, color, religion, sex, orientation, gender identity, national origin, veteran or disability status, or any other characteristic protected under applicable law. We cherish the unique contributions of our diverse staff and are building a culture where everyone has the opportunity to do the meaningful work.
As a Registered Nurse (RN) you will be part of the interdisciplinary Critical Time Transition Program (CTTP) team. You will provide clinical support and care coordination for youth with mental health needs, and their caregivers, when transitioning from hospitalization/hospital stabilization to home and community-based care. You will ensure continuity of care, promote physical and emotional wellness, and help prevent re-hospitalization by delivering health education, and medication support to both youth and their caregivers. You will report to the Director of Hospital to Home and you will work onsite and in the community.
Responsibilities
- Case Coordination: Conduct home and community visits to assess health and environmental needs. Daily follow-up with outpatient providers. Document all nursing activities and assessments. Up to 50% of time spent in the community.
- Assessment: Perform physical and mental health assessments. Monitor for health deterioration, side effects, or psychiatric decompensation. Participate in crisis prevention and emergency response planning.
- Communication & Collaboration: Guide communication between youth, caregivers, and care providers. Contribute to interdisciplinary treatment planning and team meetings.
- Education & Advocacy: Educate caregivers on treatment plans and navigating the healthcare system. Promote health literacy and advocate for access to medical and behavioral health resources.
- Discharge Planning: Support safe and coordinated transitions from hospital to home or alternate care.
- Develop connections with hospitals, clinics, and other referral sources. Collaborate with prescribers, primary care, mental health clinicians, and case managers.
- Clinical Support: Provide consultation to the treatment team on behavioral health-related concerns including crisis prevention and intervention.
- Be part of a collaborative interdisciplinary team.
- Willingness to conduct home and community-based visits.
- Knowledge: Knowledge of hospital protocols, procedures, addiction, mental health diagnosis, evaluation, and treatment. Understanding of adolescent development and behavioral health.
- NYS Registered Nurse (RN) license required
- 2+ years of nursing experience in psychiatric, pediatric, or community health settings
- Valid NYS driver's license required
- Health care package: medical, dental, and vision
- Tuition reimbursement
- Paid time off
- Holiday Pay
- 401 (K) plan
- Life Insurance
- Loan repayment assistance
- Free training/CEU opportunities
At Northern Rivers Family of Services, we work together to make a difference in our client's lives. Northern Rivers empowers children, adults, and families to change their lives and build stronger communities.
Northern Rivers Family of Services is an Equal Opportunity Employer. We hire great people from a variety of backgrounds, not because it is the right thing to do, but because it makes us stronger! All applicants will be considered for employment without attention to race, color, religion, sex, orientation, gender identity, national origin, veteran or disability status, or any other characteristic protected under applicable law. We cherish the unique contributions of our diverse staff and are building a culture where everyone has the opportunity to do the meaningful work.
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