Discharge & Care Transitions Specialist

Baycare; Florida; On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

401k match

Community discounts

Job summary

BayCare is seeking a Care Coordination Specialist at Plant City, FL to join our interdisciplinary team and support a value-based care model. You will coordinate care with patients, families, and the care team to optimize outcomes and to ensure smooth transitions to post-acute resources.

This PRN role involves coordinating discharge planning, identifying barriers such as social determinants of health, and linking patients to community resources.

Qualifications

• Bachelor's degree in social work, psychology, or healthcare field or LPN license.
• Medical Social Work or LPN experience preferred.

Responsibilities

• Coordinate care with patients, nursing, physicians, and community partners to improve outcomes.
• Provide comprehensive care coordination and discharge planning for post-acute resources.
• Identify barriers including social determinants of health to improve transitions of care.
• Coordinate transition of care and referrals, including post-acute authorizations when needed.
• Support regulatory compliance and efficient length of stay in value-based models.

Skills

Care coordination

Discharge planning

Interdisciplinary collaboration

Patient advocacy

Education

Bachelor's degree in social work, psychology, or healthcare related field OR LPN License

Job description

BayCare is seeking a Care Coordination Specialist at Plant City, FL to join our interdisciplinary team and support a value-based care model. You will coordinate care with patients, families, and the care team to optimize outcomes and to ensure smooth transitions to post-acute resources.

This PRN role involves coordinating discharge planning, identifying barriers such as social determinants of health, and linking patients to community resources.