Care Transition Specialist: Drive Patient Care Transitions

Res-Care, Inc.; Wheeling (WV); On-site; USD 65,000 - 85,000; Full time

Job summary

Adoration Health is seeking a Care Transition Coordinator to facilitate smooth transitions from healthcare facilities to home health or hospice care. You will evaluate eligibility, coordinate care plans, and arrange ancillary services in alignment with agency protocols and patient needs.

Your responsibilities include coordinating transfer orders, educating patients about discharge plans and medications, and liaising with referral sources, facilities, and clinicians to ensure timely communication

Qualifications

• Minimum of one year of experience in home health or hospital-based case management.
• Current and active licensure as RN/LPN/SW/PT.
• Valid driver’s license and reliable transportation.
• Knowledge of Medicare/insurance coverage guidelines.

Responsibilities

• Achieve monthly production goals and MC admission targets for assigned locations.
• Coordinate care plans and transfer orders with branches and providers.
• Evaluate patient eligibility for home care in accordance with guidelines.
• Educate patients on post-discharge plans and medication regimens.
• Coordinate ancillary services (DME, infusion) and educate patients on services received.
• Maintain documentation and communicate with referral sources and case management teams.
• Promote growth by aligning team efforts with referral sources and patients.

Skills

Case management

Patient education

Healthcare coordination

Sales administration

Education

RN license

LPN license

Social Worker license (SW)

Physical Therapist license (PT)

Tools

Home Care Home Base

Job description

Adoration Health is seeking a Care Transition Coordinator to facilitate smooth transitions from healthcare facilities to home health or hospice care. You will evaluate eligibility, coordinate care plans, and arrange ancillary services in alignment with agency protocols and patient needs.

Your responsibilities include coordinating transfer orders, educating patients about discharge plans and medications, and liaising with referral sources, facilities, and clinicians to ensure timely communication