Care Coordinator – Post-Discharge & In-Home Care

Segue Health Management Corp; Plano (TX); On-site; USD 45,000 - 55,000; Full time

Job summary

Segue Health is a faith-based medical practice serving the Plano area. We are seeking a compassionate Care Coordinator to oversee post-discharge transitional care management.

This role blends clinical knowledge with strong organization and communication to coordinate referrals, log data in EMR/EHR, and arrange in-home visits for patients after hospitalization. The position requires attention to detail, reliability, and a heart to serve others.

Qualifications

• Must have experience in the medical field.
• Must have knowledge of Microsoft Excel and the ability to learn EMR/EHR software.
• Must provide proof of vaccinations or meet vaccination requirements per hospital standards.

Responsibilities

• Working with referring facility to generate list of patients eligible for TCM services.
• Visiting referrals while in the facility to explain the TCM program and determine if there are any anticipated needs post discharge.
• Daily logging of referrals and discharges.
• Creating charts in EMR and uploading face sheet, H&P, and DC Summary.
• Post discharge calls to patients within 24 hours.
• Scheduling of patients preferably prior to discharge for in home visits.

Skills

Medical field experience

Microsoft Excel

EMR/EHR software

Tools

Microsoft Excel

EMR/EHR software

Job description

Segue Health is a faith-based medical practice serving the Plano area. We are seeking a compassionate Care Coordinator to oversee post-discharge transitional care management.

This role blends clinical knowledge with strong organization and communication to coordinate referrals, log data in EMR/EHR, and arrange in-home visits for patients after hospitalization. The position requires attention to detail, reliability, and a heart to serve others.