Care Transition Navigator | Post-Discharge Support

Great Lakes Bay Health Centers; Saginaw (MI); On-site; USD 36,000 - 48,000; Full time

Job summary

Great Lakes Bay Health Centers seeks a full-time Care Coordinator to support hospital-to-home transitions and follow-up care. You will identify barriers, coordinate with care teams, and educate patients to improve outcomes. Strong communication and EMR documentation are essential.

The role requires a high school diploma or GED, with CHW certification preferred, and at least two years in healthcare or care coordination. Bilingual abilities are a plus.

Qualifications

• High school diploma or GED required; associate degree preferred.
• CHW certification preferred; bilingual ability preferred.
• Minimum 2 years in healthcare, care coordination, or related field.
• Telecommunication and computing skills required; bilingual a plus.

Responsibilities

• Hospital transitions: contact patients, begin discharge planning, coordinate follow-ups.
• Post-discharge follow up: schedule and confirm appointments, reinforce instructions.
• Identify and resolve barriers to care with internal and community resources.
• Collaborate with care team to ensure continuity after discharge.
• Educate patients and families on follow-up care, meds, resources.
• Document activities in EMR and track transition performance.

Skills

Telephone skills

Computer skills

Bilingual English/Spanish

Flexible in assignments

Education

High school diploma or GED

Associates degree preferred

Tools

EMR systems

Job description

Great Lakes Bay Health Centers seeks a full-time Care Coordinator to support hospital-to-home transitions and follow-up care. You will identify barriers, coordinate with care teams, and educate patients to improve outcomes. Strong communication and EMR documentation are essential.

The role requires a high school diploma or GED, with CHW certification preferred, and at least two years in healthcare or care coordination. Bilingual abilities are a plus.