Care Transitions Coordinator

jeffersonhealth; Philadelphia (Philadelphia County); On-site; USD 70,000 - 90,000; Full time

Job summary

Jefferson Health is seeking a Discharge Planner to coordinate post-acute services and appointments for patients on the assigned unit. You will work with care managers, providers, and the transfer center to ensure timely internal and external transfers and link follow-up appointments to orders and payer requirements.

The role involves assessing psychosocial factors, providing education and referrals, and communicating with payers to obtain authorization for inpatient and post-acute services,

Qualifications

• Bachelor's Degree in a healthcare-related field.
• 2 years of experience in a healthcare-related role.
• Knowledge of HIPAA, Medicare/Medicaid, insurance, and medical terminology.
• Computer and EHR literacy; ability to schedule and coordinate patient appointments.

Responsibilities

• Coordinates safe and timely discharge by arranging all necessary post-acute services including home health, DME, transportation, infusion services, and community-based resources in collaboration with the inpatient care manager RN, MSW, Social Services Coordinator, or Social worker BSW.
• Obtains payer authorization for appropriate level of care, length of stay, and post-discharge services; ensures timely submission of clinical information and communicates payer determinations of denials to the care manager.
• Documents all discharge planning activities including authorizations, communications, and service arrangements promptly and accurately in the medical record to ensure regulatory and organizational compliance.
• Reviews and completes Medicare Notice of Hospital Discharge with inpatient and behavioral health hospital admissions for beneficiaries in hospital.
• Schedules and confirms follow-up appointments (physician, laboratory, procedural, and financial) prior to discharge, linking all appointments accurately to physician orders and payers requirements.
• Acts as a liaison between patients, families, healthcare providers, payers, and community agencies to support smooth transitions of care and ensure continuity post-discharge.
• Monitors hospital transfers by collaborating with the care management colleagues to transfer medical stable patients to their hospital of origin.
• Communicates, escalates, and prioritizes transportation needs between care management colleagues and the transfer center
• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson

Education

Bachelor's Degree healthcare related field

Job description

Jefferson Health is seeking a Discharge Planner to coordinate post-acute services and appointments for patients on the assigned unit. You will work with care managers, providers, and the transfer center to ensure timely internal and external transfers and link follow-up appointments to orders and payer requirements.

The role involves assessing psychosocial factors, providing education and referrals, and communicating with payers to obtain authorization for inpatient and post-acute services,