Inpatient Census & TOC Coordinator

Triple-S; Guaynabo (PR); On-site; USD 32,000 - 42,000; Full time

Job summary

Triple-S is seeking a Coordinator to provide operational support to the Utilization Management and Transition of Care teams in Puerto Rico. The role focuses on managing the inpatient census data, reconciling entries, and supporting TOC workflows by gathering and reviewing clinical documentation.

Responsibilities include monitoring admissions, readmissions, and level-of-care changes; coordinating post-discharge services and follow-up appointments; and liaising with home health agencies, DME

Qualifications

• Bachelor's Degree with six (6) months of experience in similar activities, or Associate degree or Technical Course with at least two-three (2-3) years of experience in operational support activities.
• Experience within a health plan organization, hospital admissions or care coordination is preferred.
• None required licenses or certifications.

Responsibilities

• Daily Inpatient Census Management Data Entry and Reconciliation: Maintain, update, and reconcile the daily inpatient census within the health plan's system based on reports from facilities.
• Status Tracking: Monitor discharges, transfers, changes in level of care, and readmissions to ensure accurate length-of-stay tracking.
• Clinical Support Escalation: Identify and notify clinical team members of new admissions or priority cases requiring concurrent review.
• Transition of Care (TOC) Operational Support: Collect clinical documentation and coordinate post-discharge services; verify completeness before upload.
• Post-Discharge Appointment Coordination: Schedule and confirm follow-up appointments with PCPs or specialists.
• Interagency Liaison: Facilitate coordination with Home Health Agencies, DME vendors, and sub-acute facilities.

Skills

Action Oriented

Collaborates

Customer Delight

Customer Delight (Employee)

Instills Trust

Manages Ambiguity

Education

Bachelor's Degree

Associate's Degree

Job description

Triple-S is seeking a Coordinator to provide operational support to the Utilization Management and Transition of Care teams in Puerto Rico. The role focuses on managing the inpatient census data, reconciling entries, and supporting TOC workflows by gathering and reviewing clinical documentation.

Responsibilities include monitoring admissions, readmissions, and level-of-care changes; coordinating post-discharge services and follow-up appointments; and liaising with home health agencies, DME