Community Transition Navigator

Paycom - ATS; Pomona (CA); On-site; USD 55,000 - 85,000; Full time

Job summary

Libertana Home Health seeks a Transition Coordinator to manage housing and discharge coordination for SNF residents, liaising with California authorities and local communities across multiple counties. You will coordinate care plans, TAR submissions, and waivers while maintaining essential documentation and compliance.

The role involves field visits, collaboration with SNFs, and ensuring seamless resident transitions back into the community, with travel across covered regions as required.

Qualifications

• Bachelor’s degree in healthcare, business administration or related field preferred.
• Intermediate PC skills including Word, Excel, PowerPoint and Access.
• Previous Health Care experience preferred.
• Background in developing reports, newsletters, brochures, statistics, and information analysis desired.
• Experience in Community Liaison in the Los Angeles community.
• Must be at least 18 years of age.
• Ability to read, write and follow instructions in English.
• Maintains good organizational skills.
• Self-directed and able to work with minimal supervision.

Responsibilities

• Assist clients with housing and transition coordination.
• Liaise between the State of California and the Community for residents from SNFs.
• Coordinate RN visits to assess residents and prepare ICP.
• Prepare and submit TARs and care plans.
• Maintain contact with SNFs and residents during care planning.
• Apply for waivers based on resident needs (ALW/NF/IHSS).
• Maintain timekeeping and credentials; report fraud and abuse.
• Attend mandated trainings and drive as needed to covered areas.

Skills

Analytical skills

Communication skills

Organizational skills

Self-directed

Education

Bachelor's degree in healthcare, business administration or related field

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Access

Job description

Libertana Home Health seeks a Transition Coordinator to manage housing and discharge coordination for SNF residents, liaising with California authorities and local communities across multiple counties. You will coordinate care plans, TAR submissions, and waivers while maintaining essential documentation and compliance.

The role involves field visits, collaboration with SNFs, and ensuring seamless resident transitions back into the community, with travel across covered regions as required.