Discharge & Care Transition Specialist

Banner Health; Phoenix, Northern (AZ, KY); Hybrid; USD 42,000 - 66,000; Full time

Job summary

Banner Health is seeking a Transition Care Assistant in Phoenix to guide patients and families through discharge, coordinating post‑acute plans with the care team. The role supports timely transitions from acute care to skilled nursing, rehab, home care or community programs.

Responsibilities include documenting plans, reviewing daily holdovers, and attending multidisciplinary rounds with physicians, nurses, nutritionists and pharmacists.

Qualifications

• Bachelor’s degree in social work or related field, or an LPN/RT license.
• Knowledge of government/community agencies (Medicare/Medicaid).
• Effective communication and customer service skills.
• Ability to work flexible hours and weekends on rotation.
• BLS certification required.
• Arizona Fingerprint Clearance Card may be required depending on role.

Responsibilities

• Facilitate the timely discharge/transition to post‑acute settings.
• Collaborate with the health care team to implement discharge plans.
• Document all interventions in the patient’s medical record.
• Perform follow-up calls to patients and providers as needed.
• Coordinate with community resources for post‑acute care.

Skills

Communication

Customer service

Interpersonal skills

Time management

Education

Bachelor's degree in social work

Licensed Practical Nurse (LPN)

Licensed Respiratory Therapist (LRT)

Job description

Banner Health is seeking a Transition Care Assistant in Phoenix to guide patients and families through discharge, coordinating post‑acute plans with the care team. The role supports timely transitions from acute care to skilled nursing, rehab, home care or community programs.

Responsibilities include documenting plans, reviewing daily holdovers, and attending multidisciplinary rounds with physicians, nurses, nutritionists and pharmacists.