Onsite Care Transitions Specialist

Optum; St. Louis (MO); Hybrid; USD 47,000 - 84,000; Full time

Job summary

OptumCare is seeking a Care Coordinator- Onsite in the United States (St. Louis area) to optimize patients’ recovery journeys. The role coordinates discharge planning with the post-acute care team, engages patients and families, and ensures smooth transitions of care.

The position follows a hybrid schedule with three in-office days per week. Responsibilities include SNF assessments, CMS criteria application, and collaboration with physicians, social workers, and rehab staff.

Qualifications

• Active, unrestricted license for RN, PT, OT, or SLP in the state of hire.
• Minimum 5+ years of clinical experience.
• Willingness to support on-site facility needs within 30 miles.
• Residence within or near the listed county.

Responsibilities

• Coordinate discharge planning with the PAC team for timely transitions of care.
• Perform SNF assessments using CMS criteria at admission and during stay.
• Engage patients and families to support informed decisions.
• Collaborate with care teams to resolve barriers to discharge.
• Maintain HIPAA compliance and confidential PHI handling.

Skills

Licensed clinician

Clinical experience

Driver's license

On-site availability

Tools

MS Office

Job description

OptumCare is seeking a Care Coordinator- Onsite in the United States (St. Louis area) to optimize patients’ recovery journeys. The role coordinates discharge planning with the post-acute care team, engages patients and families, and ensures smooth transitions of care.

The position follows a hybrid schedule with three in-office days per week. Responsibilities include SNF assessments, CMS criteria application, and collaboration with physicians, social workers, and rehab staff.