Care Transition Navigator

Graham Healthcare Group; Lewisburg (Union County); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health insurance

401k plan

Pension

Educational programs (Purdue/Kaplan)

Generous PTO

Job summary

Graham Healthcare Group is seeking a Patient Transitions Coordinator to initiate care transitions for referrals to home health, hospice, or palliative services. You will coordinate with hospital staff, nurse liaisons, and sales to ensure smooth transitions and positive outcomes for patients and families.

The role requires strong organizational and communication skills, experience in home health or discharge planning, and the ability to work with diverse teams to gather necessary information and

Qualifications

• Knowledge of referral source types and community resources.
• Excellent organizational skills and the ability to manage competing priorities.
• High energy level and passion for care delivery.
• Professional communication, patience, flexibility, and cooperative attitude.
• Ability to listen attentively and offer care options based on patient health needs.

Responsibilities

• Initiate contact for Home Health, Hospice, or Palliative services and assist in preparing acceptance of care.
• Explain benefits and coordinate clinical information to start physician‑ordered services.
• Assist Sales with referral coordination: obtain physician signatures, pull EMR data, request details from facilities, conduct bedside meetings.
• Provide follow‑up feedback to referral sources regarding admissions or non‑admit decisions.
• Collaborate with rehabilitation facilities regarding patient care needs and discharge planning.
• Assist in systems integration and processes to improve patient outcomes and transitions of care.

Skills

Referral coordination

Organization

Communication

Microsoft Office

Discharge planning

Sales experience

Tools

EMR systems

Microsoft Word

Excel

Job description

Graham Healthcare Group is seeking a Patient Transitions Coordinator to initiate care transitions for referrals to home health, hospice, or palliative services. You will coordinate with hospital staff, nurse liaisons, and sales to ensure smooth transitions and positive outcomes for patients and families.

The role requires strong organizational and communication skills, experience in home health or discharge planning, and the ability to work with diverse teams to gather necessary information and