Aftercare Coordinator: Care Transitions Lead

Parkland Community Health Plan; Dallas, Northern (TX, KY); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Parkland Health in Dallas seeks an experienced Aftercare Coordinator to assess complex post-discharge needs and develop coordinated aftercare plans. You will work with families and the care team to ensure timely referrals, appointments, and resource access, while documenting outcomes and barriers.

The role emphasizes collaboration with care managers, providers, and community partners to optimize patient transitions and supports.

Qualifications

• Clinical license or certification required.
• 3 years direct patient care experience.
• Experience coordinating aftercare plans and services.

Responsibilities

• Assesses complex patient aftercare needs, risks, support systems, service eligibility, and barriers to successful care transitions.
• Develops individualized aftercare plans addressing follow-up treatment, medications, appointments, community resources, and education.
• Coordinates referrals, authorizations, appointments, and provider communication; ensures documentation within timelines.
• Interacts with patients, families, clinical teams, payers, and external agencies to resolve transition-of-care issues.
• Mentors and guides junior staff on aftercare practices and care-transition procedures.

Skills

Problem solving

Collaboration

Growth mindset

Execution

Digital literacy

Education

Bachelor’s of Science in Nursing

Bachelor’s degree in Physical Therapy

Bachelor’s degree in Occupational Therapy

Master’s degree in Speech-Language Pathology

Master’s Degree in Social Work

Job description

Parkland Health in Dallas seeks an experienced Aftercare Coordinator to assess complex post-discharge needs and develop coordinated aftercare plans. You will work with families and the care team to ensure timely referrals, appointments, and resource access, while documenting outcomes and barriers.

The role emphasizes collaboration with care managers, providers, and community partners to optimize patient transitions and supports.